Síndrome de Cushing debido a tumor pancreático

Coloseminal vesicle fistula after low anterior resection: Report of a case and review of the literature

“…While a vasogram could be used, it is invasive, expensive and it has not been proven to be superior to the other means of investigation [ 16 ]. Moreover, one of the reported case praise for the use of MRI for the diagnosis [ 13 ]. However, as it has been described before, a potential problem with MRI is that the signal intensity of the seminal vesicles and the fluid within the fistulous tract are very similar making the visualization of the communication laborious [ 5 ].…”

“…This type of fistula on the other hand is extraperitoneal in localization and commonly low output (<200 mL/24 h). They have a good prognosis with conservative approach [ [3] , [4] , [5] , 13 , [16] , [17] , [18] ] depending on the severity of the anastomotic leak, the extend of the abscess formation and whether there is passage of urine through the fistula [ 16 ]. The case reported here supports conservative management as the patient is still symptoms free six months after treatment.…”

“…With failure of the conservative approach however, a surgical intervention has to be considered (fecal diversion, urinary diversion, intestinal resection, muscle/omental flaps ± vasostomy) [ 11 ]. Finally, the use of finasteride with a conservative approach has been described in the literature to help healing of the fistulous tract as it reduces the seminal secretions [ 4 , 13 ].…”

“…Fistulas between the colon and the seminal vesicles are rarely seen in patients. From a Medline search from 1966 to date, a total of twenty-one cases have been reported [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] ]. The etiologies of this type of fistula vary among Crohn’s disease [ 1 , 2 , 5 ], acute diverticulitis [ 9 , 11 , 12 ], operative complications of prostate [ 6 , 7 ], direct invasion by rectal cancer [ 8 ], iatrogenic perforation with transrectal drainage of seminal vesicle abscess [ 10 ] and finally, eleven of these reported cases are a direct complication of low anterior resection for rectal cancer [ [3] , [4] , [5] , [13] , [14] , [15] , [16] , [17] , [18] ].…”