Crohn’s disease is a chronic inflammatory disease with several clinical presentations. Complications usually occur after average of ten years of evolution. An enterovesical fistula complicating a Crohn’s disease is a rare situation but enterourachal fistula is even rarer. It’s a diagnosis challenging especially as an initial presentation of the disease. Few cases of entero-urachal fistula were published in literature. We present a case of 32-year-old female presented with three months history of diarrhea and had recently developed dysuria. She was admitted to our institution with fever, lower abdominal pain and sub umbilical swelling. Ultrasonography and computed tomography revealed parietal thickening of the distal ileum continuing with an infected urachal cyst which is consistent with Crohn’s disease. Ileourachal fistula was highly suspected. After medical treatment, an urachal resection, partial cystectomy and ileal resections were performed. Primary ileostomy was used and re-establishing continuity was programmed 8 weeks later. After surgery, symptoms improved significantly. The aim of our report is to describe this rare complication with a review of literature and to assess the importance of medical and surgical management.
