A 24-year-old male first experienced pollakisuria, dysuria, pneumaturia and diarrhea in May 1988. Intravenous pyelography showed a normal upper urinary tract but bladder wall irregularity at the dome was observed. Cystoscopic examination revealed bullous edema, erythema and presence of a mucous-like substance. Barium enema X-ray examination revealed inflammatory changes at the terminal ileum but no fistulous connection was noted. Mild ulceration was observed on colon fiberscopic examination. At operation, a severely inflamed lower ileum firmly adherent to the dome of bladder as well as to the sigmoid colon was observed. Fistulous communication between bladder and ileum was also noted. Resection of diseased ileum, sigmoid colon and partial cystectomy were carried out. The patient remains well, without enteric or bladder symptoms.