A 79 yo lady who is otherwise well recently started abdominal pain. She is afebrile and
complains that she passed air bubbles during urination. A urethral catheter showed fecal
leakage in the urinary bag. What is the likely pathology?
a. Diuretics
b. CD
c. Rectosigmoid tumor
d. Large bowel perforation
e. UC
Ans. The key is B. CD. [debate came that Crohn’s disease cannot occur in 79 yrs but this is not the case!
“Crohn’s disease can occur at any age, but is most frequently diagnosed in people ages 15 - 35. About
10% of patients are children under age 18”. [http://www.nytimes.com/health/guides/disease/crohns-
disease/risk-factors.html]. So I think it can occur in this age also and the feature like fistula is a common
association of CD].