Radiographic and clinical sequelae of the duodenocolic anatomic relationship: two cases of Crohn's disease with fistulization to the duodenum.

The posterior surface of the proximal transverse colon and the anterior surface of the descending duodenum are intimately related. The clinical importance of this apposition is re-emphasized with presentation of two cases which had the uncommon phenomenon of benign duodenocolic fistula. These two rare cases of duodenocolic fistulas secondary to Crohn's disease are added to the literature. It is also suggested that in some cases, duodenal mucosal alterations with adjacent Crohn's disease of the colon might be the result of reactive inflammatory changes, and do not necessarily indicate continuous extension of the granulomatous disease.

Effects of inguinal hernias upon the bladder and ureters.

The presence of inguinal hernia may be associated with extrinsic defects upon the bladder and ureter in the absence of actual herniation of the urinary structures. The findings are characteristic unless associated with irregularity of the bladder wall or elevation of the bladder floor by prostatic enlargement. In some cases, the possibility of intrinsic bladder pathology is raised, requiring retrograde study for clarification. Ureteral displacements may be either ipsilateral or contralateral, depending upon the segment of bowel involved and the side of the hernia. The bladder findings are best demonstrated when the patient is prone or upright.