Manifestaciones clínicas, diagnóstico y tratamiento quirúrgico de una complicación intestinal en paciente con enfermedad inflamatoria

Blind colonic fistula is a rare intestinal complication of Crohn’s disease, characterized by the formation of fistulous tracts without visible external communication. Its diagnosis poses a clinical challenge due to the absence of specific signs and its similarity to other abdominal pathologies. A case study was conducted based on the clinical, imaging, and histopathological evaluation of a patient with a blind colonic fistula secondary to Crohn’s disease. Additionally, a systematic review was carried out in indexed biomedical databases (2018-2024), selecting relevant articles on the diagnosis and treatment of this condition. The results revealed that in the analyzed clinical case, the patient presented with chronic abdominal pain and partial intestinal obstruction. Imaging studies using a contrast enema revealed stenosis at the intestinal anastomosis and the presence of a blind fistula. Histopathological analysis confirmed transmural inflammation with the formation of non-caseating granulomas and fibroblastic proliferation. The patient underwent surgery, with a favorable postoperative outcome. It was concluded that blind colonic fistula should be considered in patients with Crohn’s disease and symptoms of intestinal obstruction with no apparent cause. Timely diagnosis through imaging techniques and histopathological studies is essential to guide treatment. Surgical intervention may be necessary in advanced cases, highlighting the importance of a multidisciplinary approach in managing these complications.