Intestinal perforations and fistulas are common complications of Crohn’s disease. However, chronic perforation with peritoneal space to rectal and vaginal fistulas have not been previously reported. A 38-year-old female suffered from progressive lower abdominal pain, diarrhea and weight loss. Terminal ileal chronic perforation with intra-abdominal abscess, peritoneal space to rectal and vaginal fistulas were noted. The patient received surgical resection of the cecum and terminal ileum, and then vedolizumab treatment. Three months later, she had complete fistula closure, and her body mass index had increased from 13 to 22. Vedolizumab combined with stool diversion is effective at treating Crohn’s disease with chronic perforation and complex peritoneal space to rectal and vaginal fistulas.

中文翻译：

---

维多珠单抗联合手术切除成功治疗克罗恩病腹腔穿孔至直肠阴道瘘一例

肠穿孔和瘘管是克罗恩病的常见并发症。然而，以前没有报道过直肠和阴道瘘的腹膜空间慢性穿孔。一名 38 岁女性患有进行性下腹痛、腹泻和体重减轻。回肠末端慢性穿孔伴腹腔内脓肿，腹膜间隙直肠和阴道瘘。患者接受盲肠和回肠末端手术切除，然后接受维多珠单抗治疗。三个月后，瘘管完全闭合，体重指数从13增加到22。维多珠单抗联合大便改道治疗慢性穿孔和复杂腹膜间隙至直肠和阴道瘘的克罗恩病有效。