Crohn's disease: “Its gynecologic aspect”

Complication of Crohn's disease on the vulva treated as a Bartholin's gland abscess: A case report

“…5 Gynecologic complications of Crohn's disease were able to precede active bowel problems and colonoscopic confirmation of Crohn's disease. The gynecologic complication of Crohn's disease was considered an enteric fistula to the vagina, uterus, perineum, vulva, and perianal site.…”

Case 3

“…Approximately 25% of patients with Crohn's disease present initially with perianal lesions 5 . Women with Crohn's disease have been reported to have gynaecological features in up to 25% of cases 6 . Vulval ulcers may be the presenting feature in 25% 6 .…”

Granulomatous Vulvitis, Granulomatous Cheilitis: A Single Diagnosis?

“…Most of those etiologies were ruled out by investigative tests but, in the absence of the intestinal Crohn’s disease, the diagnosis of Crohn’s disease of the vulva could not have been made. Indeed the gynecological aspect may precede the intestinal involvement in Crohn’s disease for many years [2, 4, 5, 6] and during this time there is no argument to identify the affection otherwise than as ‘vulvitis granulomatosa’.…”

“…Injection of steroids into the lips (no more than 1 ml/cm of an aqueous solution of triamcinolone acetonide 10 mg/ml with 1–2% xylocaine hydrochloride [20, 25]) might be helpful but, if it decreases the swelling, it does not represent a curative therapy [8, 20, 25] and it is painful [8, 25]. In all cases, in the literature, surgical excision was proposed but should remain a last resort in such a recurrent disease [4, 6, 16, 17]. …”

“…Oral and vulvar granulomatous lesions may herald the intestinal Crohn’s disease [2, 4, 5, 6, 7, 8, 11, 14, 19, 20, 23, 24], therefore a complete gastrointestinal investigation for Crohn’s disease, including a sigmoidoscopy, a barium enema, a barium meal and blood tests is strongly recommended with a careful follow-up at 6-month intervals [2, 5, 8, 20, 23]. …”