Images – Appendico-vesical fistula

Abstract

Appendico-vesical fistula (AVF) is an uncommon type of enterovesical fistula that can present with symptoms of recurrent or persistent urinary tract infection (UTI) and, in some instances, with gastrointestinal symptoms. AVFs occur more commonly in males and are mainly attributed to unrecognized or conservatively managed appendicitis.1 Herein, we describe a case of a 21-year-old male who presented with fevers, urgency, and hematuria and on extensive workup was found to have an AVF requiring surgical repair. Drawing from our case and the literature, we conclude that AVF occurs rarely and requires a high index of suspicion among physicians. Past medical history of previous acute appendicitis and UTIs with or without gastrointestinal symptoms should raise suspicion for AVF.