Extensive trans-organ urogenital fistulation in Crohn’s disease involving the bowel, urinary bladder, seminal vesicles, and prostate: Radiological perspective of a case

Fistulas of the prostate and seminal vesicles are rare and hence a poorly understood complication of Crohn's disease (CD), often presenting with non-specific urinary symptoms. We report a case of a 27-year-old male with an 11-year history of poorly managed CD who developed complex trans-organ fistulous tracts. Magnetic resonance images revealed an extensive fistulizing disease and intra-fistulous abscess formation involving the bowel loops, urinary bladder, seminal vesicles, and prostate gland. Several complex types of fistulas, including perianal and intra-abdominal fistulas, have been described in advanced fistulizing CD; however, prostatic involvement is scarcely documented in the literature. This paper highlights the critical role of radiological imaging in accurately detecting and interpreting rare and complex cases to guide effective management.