Unusual case of duodenobiliary fistula complicating Crohn’s disease successfully treated with Adalimumab

Publication date: Available online 9 December 2016
Source:Arab Journal of Gastroenterology
Author(s): Aya Hammami, Aida Ben Slama, Hanen Jaziri, Wafa Ben Ameur, Imed Ben Mansour, Ahlem Brahem, Salem Ajmi, Hela Jemni, Mehdi Ksiaa, Ali Jmaa
Crohn's disease (CD) is characterized by transmural inflammation of the gastrointestinal tract, which predisposes to the formation of fistula. Duodenal involvement occurs in less than 5% of cases and often leads to clinically relevant strictures. However, fistula formation in the duodenum is exceptional. Herein, we report an unusual case of duodenobiliary fistula due to CD occurring in a 65-year-old patient who was successfully treated by anti-tumor necrosis factor (TNF) agents. This case report highlights the efficacy of anti-TNF alpha agents in the treatment of a bilioenteric fistula because it increases the probability of clinical remission and mucosal healing and therefore reduces the need for surgical treatment which may be associated morbidity.



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