A 36-year-old man with severe Crohn disease complicated by urethral strictures and enterocutaneous and enterovesicular fistulas presented for several weeks of poor appetite, weight loss, failure to thrive, and newly worsening altered mentation. Further history revealed he chronically did not urinate through his urethra, but rather "leaked" through multiple enterocutaneous fistulas in his abdomen and perineum. Medications included ustekinumab (anti-IL12/IL23 monoclonal antibody) for Crohn disease, methadone, and hydrocodone. He had had multiple surgeries because of fistulas related to his Crohn disease, which included subtotal colectomy with ileostomy creation, proctectomy, and ischiorectal flap creation. He drank 10-15 ounces of liquor per week, smoked 10 cigarettes daily, and smoked marijuana weekly.

中文翻译：

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一名 36 岁克罗恩病合并双侧胸腔积液的患者。


一名 36 岁男性，患有严重克罗恩病，并发尿道狭窄和肠皮肤和肠泡瘘，表现为食欲不振、体重减轻、生长迟缓和新近恶化的精神状态改变数周。进一步的病史显示，他长期不通过尿道排尿，而是通过腹部和会阴的多个肠皮瘘“漏尿”。药物包括治疗克罗恩病的乌司奴单抗（抗 IL12/IL23 单克隆抗体）、美沙酮和氢可酮。由于与克罗恩病相关的瘘管，他接受了多次手术，其中包括结肠次全切除术联合回肠造口术、直肠切除术和坐骨直肠皮瓣切除术。他每周喝 10-15 盎司的酒，每天抽 10 支烟，每周吸大麻。