We describe a patient with Crohn’s disease who presented with a persistent enterocutaneous fistula. Colonoscopy showed no abnormalities in the terminal ileum and cecum. The patient was treated with corticosteroids and azathioprine for Crohn’s disease. The fistula responded partially to therapy. Surgery was performed and revealed a well-differentiated adenocarcinoma, originating from the fistulous tract. In persistent enterocutaneous fistulae surgery is indicated and could keep us from shocking surprises.
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