Fistulas complicating diverticulitis

Vasilevsky, Carol Ann; Belliveau, Paul; Trudel, Judith L.; Stein, Barry; Gordon, Philip H.

doi:10.1007/s003840050135

Cited by 68 publications

(61 citation statements)

References 10 publications

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“…2,3 Colocutaneous fistulas represent 6% of diverticular fistulas but are usually draining to the abdominal wall and almost always are a complication of surgery on the bowel and only very rarely occur spontaneously. 6 To our knowledge, only 2 cases have been reported of sigmoid diverticulitis presenting with isolated gluteal and thigh soft tissue infection without any gastrointestinal symptoms.…”

Section: Discussionmentioning

confidence: 99%

Left-Sided Sigmoid Diverticulitis Presenting as Right-Sided Thigh Abscess

Murphy

Belliveau

2013

International Surgery

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Acquired diverticular disease of the colon is very common in the North American population. Atypical presentations are usually due to complications and rarely the predominant complaint may be related to an associated fistula. Thigh abscesses due to colocutaneous fistula represent an uncommon complication of sigmoid diverticulitis. In rare cases, a thigh abscess may be the only symptom, but gas in the thigh should raise the index of suspicion for bowel pathology. We report the second known case of a left-sided sigmoid diverticulitis leading to an isolated right thigh abscess with no gastrointestinal symptoms.Key words: Diverticulitis -Colocutaneous fistula -Sigmoid colon -Surgery A cquired diverticular disease of the colon is very common in the North American population, affecting up to 10% of persons greater than 45 years of age and approximately 80% of those over 85.

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Section: Discussionmentioning

confidence: 99%

Left-Sided Sigmoid Diverticulitis Presenting as Right-Sided Thigh Abscess

Murphy

Belliveau

2013

International Surgery

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“…Retrograde barium enemas have been successful in visualizing fistulous tracts in only less than 40% of cases. [3][4][5][6] Colonoscopy and cytoscopy, including biopsy, are essential procedures for making differential diagnoses between malignancy and benignity but are of limited diagnostic value in showing fistulas. 2,5 Magnetic resonance imaging shows high tissue specificity and has proved highly sensitive for both detecting fistulas and investigating their morphologic characteristics.…”

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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“…Resection and primary anastomosis with colostomy and/or the Hartmann procedure (two-stage operation) are performed for patients in poor condition. The traditional three-stage operation is now seldom undertaken due to advances in intensive care and the development of antibiotics (4). Since the fistula tract is not obvious or associated with an abscess in most cases, surgical management of the bladder varies considerably.…”

Section: Sigmoid Colonmentioning

confidence: 99%

“…The major cause of this entity is malignancy, followed by diverticulitis, especially sigmoidal diverticulitis (1). In Western countries, as diverticulitis is relatively common, there are frequent reports of enterovesical fistula followed by those dealing with diverticulitis (2)(3)(4). In Asian countries, however, enterovesical fistula is rarely observed (5).…”

Section: Introductionmentioning

confidence: 99%

Vesico-ileosigmoidal Fistula Caused by Diverticulitis: Report of a Case and Literature Review in Japan

et al. 2003

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Enterovesical fistula is a relatively uncommon complication of colorectal and pelvic malignancies, diverticulitis, inflammatory bowel disease, radiotherapy, and trauma in Asian countries. A case of vesico-ileosigmoidal fistula and a literature review of this disease in Japan are presented. A 70-yr-old male was referred with complaints of urinary pain and pneumaturia. On admission, urinary tract infection and pneumaturia were presented. A barium enema demonstrated multiple diverticulum in his sigmoid colon and the passage of contrast medium into the bladder and ileum. Under the diagnosis of vesico-ileosigmoidal fistula due to suspected diverticulitis of the sigmoid colon, sigmoidectomy and partial resection of the ileum with partial cystectomy were performed. The histopathology revealed diverticulosis of the sigmoid colon with diverticulitis and development of a vesico-ileosigmoidal fistula. No malignant findings were observed. Until the year 2000, a total of 173 cases of vesico-sigmoidal fistula caused by diverticulitis had been reported in Japan. Pneumaturia and fecaluria are the most common types, presenting symptoms in 63% of the cases. Computed tomography, with a sensitivity of 40% to 100%, is the most commonly used diagnostic study. For patients with vesico-sigmoidal fistula, resection of the diseased sigmoid colon and partial cystectomy with primary anastomosis are the safest and most acceptable procedures, leading to the best results.

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Fistulas complicating diverticulitis

Cited by 68 publications

References 10 publications

Left-Sided Sigmoid Diverticulitis Presenting as Right-Sided Thigh Abscess

Left-Sided Sigmoid Diverticulitis Presenting as Right-Sided Thigh Abscess

Vesicosigmoidal Fistula

Vesico-ileosigmoidal Fistula Caused by Diverticulitis: Report of a Case and Literature Review in Japan

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