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[Enterovesical fistula in diverticulitis]
A C van Breda Vriesman1, T P de Rooij, C Ulrich
1Afd. Radiologie, Westeinde Ziekenhuis, Den Haag.
Nederlands Tijdschrift Voor Geneeskunde
|May 9, 2000
Summary
Enterovesical fistulas, often caused by sigmoid diverticulitis, present with symptoms like pneumaturia. Early diagnosis using imaging techniques is crucial for effective treatment and patient recovery.
Area of Science:
- Urology
- Gastroenterology
- Surgical Oncology
Background:
- Enterovesical fistula is a rare but serious complication, often stemming from diverticular disease of the sigmoid colon.
- Patients may present with non-specific urinary symptoms, potentially delaying diagnosis.
Observation:
- Three male patients (aged 38-60) presented with dysuria, recurrent cystitis, and notably, pneumaturia.
- Pneumaturia, the passage of air in the urine, was a key indicator observed in all affected individuals.
- Diagnostic imaging, including ultrasound and computed tomography, was instrumental in visualizing air within the bladder and identifying the fistulous tracts.
Findings:
- All three cases confirmed enterovesical fistula as a complication of sigmoid diverticulitis.
- Surgical intervention, specifically sigmoid resection, led to successful recovery in all patients.
- The study highlights the diagnostic significance of pneumaturia and fecaluria in suspected enterovesical fistulas.
Implications:
- Clinicians should maintain a high index of suspicion for enterovesical fistula in patients with suggestive symptoms, particularly pneumaturia.
- Advanced imaging modalities play a vital role in confirming the diagnosis and guiding surgical planning.
- Prompt surgical management of sigmoid diverticulitis-related enterovesical fistulas ensures favorable patient outcomes.