Baird D R, Orangio G R, Lucas G W
Department of Surgery, Georgia Baptist Medical Center, Atlanta.
South Med J. 1991 Mar;84(3):389-91. doi: 10.1097/00007611-199103000-00020.
A high index of suspicion of an ileogenital fistula should be aroused by a patient with Crohn's disease, weight loss, malnutrition, and a persistent vaginal discharge. Preoperative gastrointestinal and genitourinary evaluation should be used in an attempt to localize the fistulous origin as well as concomitant fistulae. The principles of surgical therapy include preoperative ureteral catheters, resection of the diseased bowel and fistulous segment of bowel, and interposition of healthy tissue (ie, omentum) between the bowel anastomosis and the vaginal cuff.
患有克罗恩病、体重减轻、营养不良且伴有持续性阴道分泌物的患者，应高度怀疑存在回肠生殖瘘。术前应进行胃肠道和泌尿生殖系统评估，以试图确定瘘管的起源以及并存的瘘管。手术治疗原则包括术前放置输尿管导管、切除病变肠段和肠瘘段，以及在肠吻合口和阴道断端之间置入健康组织（即大网膜）。
