Vedolizumab in Crohn’s disease with rectal fistulas and presacral abscess: A case report

Figure 1 Endoscopic findings. A: Terminal ileal shallow ulcer at diagnosis; B and C: Multiple rectal fistula tracts with inflammation; D: Mucosal healing without fistula tracts six months after vedolizumab treatment, seven months after diagnosis.

Figure 2 Magnetic resonance imaging at diagnosis. A: Liver cirrhosis with ascites; B: Rectoprostatic fistula; C: Rectopresacral fistula; D: Presacral abscess.

Figure 3 Pathology. A: Ulcer with acute on chronic inflammation and granulation tissue at diagnosis; B: Pathological presentations of cytomegalovirus (CMV) infection, immunohistochemistry stain (20 × objective) was performed with 1:200 diluted Novocastra™ lyophilized mouse monoclonal antibody against CMV pp65 antigen and showed strong focal CMV immunoreactivity with brownish areas; C: Minimal inflammatory cells infiltration six months after vedolizumab treatment, seven months after diagnosis.

Figure 4 Lower gastrointestinal series showed no more rectal fistula tract.

Figure 5 Magnetic resonance imaging seven months after diagnosis. A: No more rectal fistula tract; B: No more presacral abscess.