PMC5908384_01
CT revealed a loop-like ileum and ileo-ileal fistula with adjacent fat stranding. Black arrow: a loop-like ileum, white arrow: ileo-ileal fistula, white arrow-head: oral side ileum, black arrow-head: anal side ileum.
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CT showed a loop-like ileum and ileo-ileal fistula with adjacent fat stranding (Fig. 1).
Intraoperative findings: Approximately 50 cm from the terminal ileum, a loop-like adhesion of the ileum approximately 15 cm in length was observed. These intestines were markedly reddened and indurated.
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These intestines were markedly reddened and indurated (Fig. 2).
Comparison of nutritional data before and after surgery: After operation, hypoproteinemia, anemia and hypocholesterolemia were resolved without any medication.
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Nutritional statuses including hypoproteinemia, anemia and hypocholesterolemia were completely improved after the operation without any medication (Fig. 3).
The resected specimen demonstrated an approximately 2 cm ileo-ileal fistula in the loop-like adhesion (white arrow). Circumferential ulceration was observed around the fistula.
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The resected specimen demonstrated an approximately 2 cm ileo-ileal fistula in the loop-like adhesion, as well as circumferential ulceration continuous with the fistula (Fig. 4).
A pathological examination found ulceration and inflammatory granulation tissue around the fistula. In addition, acute and chronic inflammation and marked fibrosis were noted. There was no evidence of inflammatory bowel disease or malignancy.
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There was no evidence of inflammatory bowel disease or malignant transformation (Fig. 5).