Granulomatous bowel disease presenting as a bladder tumor

A case of Crohn's disease of the terminal ileum and rectosigmoid, with extension to the bladder by contiguity from the former, which was thought to be a vesical neoplasm, is presented in detail. In spite of the frequency of ileal involvement by granulomatous disease, bladder extension is infrequent. Evaluation of the vesical lesion alone may present serious difficulties in diagnosis. The presence of known granulomatous disease of the bowel suggests the possibility of secondary involvement of the bladder, but this cannot be considered to be conclusive without further evaluation.