Complications associated with migration are occlusion and internal fistulas
[3, 5, 7].
Management of internal fistulas
in Crohn's disease.
Key steps are visualization of the fistula tract, correct localization of the internal fistula opening under direct vision and endoscopic treatment of the fistula.
But the main place where VAAFT fits the most are the Complex and High lying Fistulas where the other competitors like Seton is controversial.7,8 While in the Endorectal Advancement Flap along with the application of Fibrin glue the success rate is reaching only 54%.9 The Ligation of internal Fistula Tract (LIFT Procedure) needs high expertise with success rate ranging from 57% to 95%.10-12
Abdominal comput- ed tomography (CT) showed a heterogeneous renal mass containing a staghorn stone that had invaded the duodenum (an internal fistula
), air localized in the right renal pelvis, and a thrombosed inferior vena cava.
In the case of Abdullah Kamel, he had severe internal fistulas
that were causing obstruction in the last section of his small bowel and large bowel."
They can connect the gallbladder with the biliary tree and rarely involve the gastrointestinal tract (internal fistulas
) and the abdominal wall (external fistulas) .