Diagnosis and Surgical Management of Colovesical Fistulas Due to Sigmoid Diverticulitis

Melchior, Sebastian; Cudovic, Dragan; Jones, Jon; Thomas, Christian; Gillitzer, R.; Thüroff, Joachim W.

doi:10.1016/j.juro.2009.05.022

Cited by 123 publications

(117 citation statements)

References 18 publications

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“…The aim of the diagnostic procedure for colovesicular fistula is to seek appropriate therapeutic strategy by assessing the existence of fistula and the underlying etiology. Resection of the inflamed bowel and primary repair of the bladder wall is the treatment of choice [3,4]. Similar cases have been reported in literature but in older population [5].…”

Section: Discussionsupporting

confidence: 52%

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Colovesical Fistula: A Rare Complication of Diverticulitis in Young Male

Jain¹

2015

JCDR

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A 30-year-old male patient who presented to a tertiary care centre with complaints of fecaluria since one month, not associated with fever, pain in abdomen or symptoms of urinary tract infection. Bowel habits were normal. Patient was on medications for diabetes and hypothyroidism since five years. On physical examination no abnormality was detected. Per Rectal Examination and proctoscopy were normal. Haematological investigation revealed no abnormality. Urine investigations revealing features of urinary tract infection. Patient underwent contrast enhanced CT scan of abdomen and pelvis, which was suggestive of a fistulous communication between the sigmoid diverticuli and urinary bladder [ Herniation of colonic mucosa through the circular muscles at the point of penetration of blood vessels results in diverticuli formation. It is seen most commonly in the large bowel in sigmoid colon. Common complications of diverticular disease are inflammation and bleeding per rectum and rarely fistula formation which are seen mostly in elderly patients. A case of colovesical fistula with diverticulitis in young male aged 30 years is reported.keywords: Communication, Fecaluria, Inflammatory, Sigmoid diverticuli urethral catheter. The post-operative recovery was uneventful. The patient was discharged on postoperative day 15 and had no urinary complaints during two months of follow up.

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Section: Discussionsupporting

confidence: 52%

“…The common clinical presentations are the symptoms of urinary tract infection, pneumaturia and fecaluria. Fecaluria is pathognomonic for this condition.There is a delay in diagnosis in some cases as patient may just have some features suggestive of urinary tract infection [3].…”

Section: Discussionmentioning

confidence: 99%

Colovesical Fistula: A Rare Complication of Diverticulitis in Young Male

Jain¹

2015

JCDR

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“…The diagnosis of an enterovesical fistula poses a significant challenge A B more importantly it provides essential additional information about the adjacent anatomical structures [5,29] . In this case it was initially used cystoscopy and cystography as the patient was managed by the urologist because of his clinical signs.…”

Section: Discussionmentioning

confidence: 99%

“…Cystoscopy has the capability to identify potential but nonspecific lesions, such as erythema, oedema, and congestion. Even though cystoscopy can fail to detect EVf in 54-65 % of cases, its use is essential for the entire investigation process [4,6,28,29] . Considering that 10%-15% of colovesical fistulae are secondary to neoplasms, colonoscopy should be part of the diagnostic work-up of EVf in order to determine the bowel pathology responsible for the fistula formation [4,5,29] Cystography can demostrate the presence of contrast outside the bladder but may not a fistula [29] its detection rate for EVf ranges between 20% and 30% [30] .…”

Section: Case Reportmentioning

confidence: 99%

A Rare Cause of Entero-Vesical Fistula Caused by a Skewer, Multidisciplinary Management and Minimally-Invasive Surgical Correction

Campagnacci¹

2014

Surgery

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Entero-vesical fistulae (EVf) occurs rarely but it is a serious clinical condition often correlated with other pathologies. It accounts for 1 to 3000 hospital accesses/year. We present a patient with a sigmoid-vesical fistulae caused by the accidental ingestion of a wood skewer two years before. In literature about 6,09 % of accesses in the first aid area(FAa) are due to the ingestion of foreign bodies(FBs) but in 80-90% of them they are expelled with stools. In frequently FBs in the lower gastrointestinal tract can be the result of an orally ingested sharp object that becomes impacted. The management of this case was multidisciplinary, and the correction was a laparoscopic one time approach.

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“…Some researchers 1,2 reported that the poppy seed test was the best procedure for detecting colovesical fistulas with high sensitivity in terms of cost savings compared with imaging modalities such as CT, magnetic resonance imaging, and cytoscopy. Some imaging modalities, however, are essential diagnostic procedures because the presence of colon or bladder cancer as an underlying cause of a VSF will determine the course of further therapy.…”

Section: Discussionmentioning

confidence: 99%

Vesicosigmoidal Fistula

Fujii

Moriguchi

Taniguchi

2010

Journal of Ultrasound in Medicine

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vesicosigmoidal fistula (VSF), a pathologic communication between the urinary bladder and the sigmoid colon, is a relatively rare condition with various causes, such as trauma, inflammation, and malignancy. Vesicosigmoidal fistulas account for about half of the fistulas resulting from diverticulitis. Most patients with a VSF present with urinary tract symptoms, including urinary urgency, dysuria, pneumaturia, and fecaluria. Recurrent urinary tract infections in an elderly man should increase suspicion. Despite the presence of obvious symptoms, the diagnosis of a VSF can be difficult to establish conclusively. To date, the diagnosis of a VSF remains a challenge without a reference standard. We encountered a case of a VSF due to sigmoid diverticulitis in which abdominal sonography helped us make a very early diagnosis. To the best of our knowledge, the sonographic findings of a VSF have not been reported in English previously. Case ReportA 60-year-old man with poorly controlled diabetes mellitus (hemoglobin A1c value of 9.5%) was admitted after having painful muscle cramps in the lower limbs. Heat cramps and a urinary tract infection were soon diagnosed. Although he had a remission of the muscle cramping for a few days, fecaluria and dysuria, which he had for a few months, persisted. He had no history of abdominal trauma or sigmoidal diverticulitis. Physical examination revealed slight tenderness in the center of the lower abdomen. No abdominal masses were palpable. In the laboratory tests, leukocytosis (10,000-20,000/µL), elevation of his C-reactive protein level (3.0-5.0 mg/dL), and leukocyturia were persistently found. A urine culture revealed more than 10 4 /mL of Escherichia coli. Although appropriate antibiotics for treating this bacterium were administered, both the leukocyturia and the urinary symptoms remained.

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Diagnosis and Surgical Management of Colovesical Fistulas Due to Sigmoid Diverticulitis

Cited by 123 publications

References 18 publications

Colovesical Fistula: A Rare Complication of Diverticulitis in Young Male

Colovesical Fistula: A Rare Complication of Diverticulitis in Young Male

A Rare Cause of Entero-Vesical Fistula Caused by a Skewer, Multidisciplinary Management and Minimally-Invasive Surgical Correction

Vesicosigmoidal Fistula

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