Oophorovesicular-colonic fistula: a rare complication of Crohn's disease.

Salpingitis and vesicular fistulas are rare complications of Crohn's disease. In this report the authors describe a case of oophorovesicular-colonic fistula secondary to Crohn's disease. The patient presented with bleeding from the bladder during menstruation, fecaluria and pneumaturia. A single-stage left salpingo-oophorectomy, sigmoid resection and repair of the fistula were carried out, with complete resolution of symptoms and preservation of fertility potential.

Dilation and evacuation: a preferred method of midtrimester abortion.

A comparison between two methods of therapeutic termination of midtrimester pregnancies was performed. Twenty-nine patients at 13 to 16 weeks' gestation underwent dilation and evacuation (D and E). A second group, of 29 patients at 16 to 19 weeks' gestation underwent therapeutic abortion by prostaglandin F2 alpha instillation. There was a significantly lower complication rate (6.9% versus 55%) and a shorter hospital stay of 1 full day in the D and E group. Also, the blood loss was not significantly greater in the D and E group.

PIP: 2 methods of therapeutic termination of midtrimester pregnancies were compared. 29 consecutive private patients requesting abortion at 13-16 weeks' gestation underwent dilation and evacuation (D and E). 29 patients at 16-19 weeks' gestation underwent therapeutic abortion by prostaglandin F2alpha instillation. The 2-day mean stay of the D and E group was significantly less than the 3.07 days of the group who underwent therapeutic abortion by prostaglandin F2alpha instillation. No significant difference in blood loss was observed in the 2 groups. There was a significantly lower complication rate (6.9%) versus 55%) in the D and E group. In sum, it appears that D and E should be the method of choice for early midtrimester abortions because of its safety, efficiency, and practicality.