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Related Experiment Videos

[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
PubMed
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.

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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.

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