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

Abstract

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.

Laparoscopic Treatment of an Atypic Vezicosygmoid Fistula

“…Kadınlarda erkeklere göre 3.5 kat daha fazla görülmektedir. Bu fark literatürde histerektomi sonrasında yüksek oranda gözlenmesine bağlanmıştır [3] .…”

Enterovesikale Fisteln

“…Eine Divertikulitis ist die häufigste Ursache [2][3][4][5][6][7][8][9]14] in etwa 50 bis 70% der Fälle, fast immer kolovesikal. Obwohl das relative Risiko zur Entwicklung einer EVF bei Vorliegen einer Divertikelkrankheit unbekannt ist, berichten die meisten Studien ein 1-4%iges Risiko [6,7,13,15].…”

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

“…The clinical presentation of EVf is characterized by pneumaturia, fecaluria and, recurrent urinary tract infections [2,4,22,23]. Other symptoms are abdominal pain that occurs in the 40 % of patients and fever related with infections or inflammation [2,24,25]. The presentation is more often related to the urinary tract as the high pressure in the bowel tract define an unidirectional flow to the bladder [26,27].…”

“…The colovesical are 70% , the ileovesical are 15% and the rectum-vesical are 10% [1] . They occur more frequently in male, about three times than female [2], due to the presence of the uterus. EVf can be caused by embriological abnormalities, infections, inflammatory bowel diseases, tumours, trauma and iatrogenic lesions [3].…”

“…At least there are FBs in the lower gastrointestinal tract like chicken bones and fish bones or Foley's catheter in the bladder. The clinical presentation of EVf is characterized by pneumaturia, fecaluria and, recurrent urinary tract infections [2,4,22,23]. Other symptoms are abdominal pain that occurs in the 40 % of patients and fever related with infections or inflammation [2,24,25].…”