Ovarian involvement in Crohn´s disease: A rare complication.

BACKGROUND: The transmural condition of Crohn's disease predisposes to fistulae or abscesses. The internal fistulae incidence is about 15%. Among them, enteroovarian fistula is rarely described on the literature. Herein, the authors present three cases of enteroovarian fistulas.

CASE REPORTS: Two women are diagnosed with ileal Crohn's disease that presented a pelvic abscess diagnosed by ultrasound and CT. On surgery, an inflammatory mass involving the ileum and the ovary was found. The third woman was operated because of a tuboovarian abscess and was diagnosed with ileal Crohn's disease afterwards. In the three cases, the histopathological analysis of the ovary showed granulomas with abscess compatible with Crohn's disease. In one of the cases, multinucleated giant cells were found in the foreign body reaction to vegetable matter. A right ileocolectomy and an adnexectomy were performed in all three cases. No further involvement of the contralateral ovary or other gynaecological complications was observed.

DISCUSSION: The treatment of Crohn's disease complications should be individualised. In the case of ovarian involvement, surgical treatment should include adnexectomy.