Colovesical fistulae in the sigmoid diverticulitis

Area of Science:

• Gastroenterology and Surgical Oncology
• Colorectal Surgery
• Diverticular Disease Complications

Background:

• Colovesical fistulae are abnormal connections between the colon and bladder, most commonly arising from sigmoid diverticulitis.
• Other less frequent colodigestive fistulae include colovaginal, colocutaneous, coloenteric, and colouterine types.
• This review focuses on colovesical fistulae in the context of colorectal surgery for sigmoid diverticulitis.

Observation:

• Two surgical cases of colovesical fistula secondary to sigmoid diverticulitis were treated.
• One case was elective, while the other presented as an emergency.
• Both patients underwent sigmoid resection with primary anastomosis and a small bladder (vesical) window excision.

Findings:

• Sigmoid resection with primary anastomosis and vesical window-ectomy is a viable surgical strategy for colovesical fistulae.
• Post-operative management included the use of a Foley catheter for approximately 10 days.
• This surgical approach achieved successful outcomes in the reported cases.

Implications:

• The findings support sigmoid resection as an effective treatment for colovesical fistulae originating from diverticular disease.
• This surgical technique minimizes complications and allows for primary closure, potentially reducing hospital stay.
• Further research could explore long-term outcomes and compare different surgical techniques for managing these complex fistulae.