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[Unusual presentation of sigmoid diverticulitis. Sigmoid-vesical fistula in sigmoid diverticulitis]
1Institut für Diagnostische, Interventionelle und Pädiatrische Radiologie, Inselspital, Universitätsspital Bern, CH-3010, Bern, Schweiz.
Abstract:
A 68-year-old male patient presented with mild tenderness in the suprasymphyseal region, hematuria and dysuria. In this case typical symptoms of a sigmoid-vesical fistula were initially absent. Because of hematuria and the findings provided by urethrocystoscopy, the radiological diagnosis was a bladder tumor. Contrast-enhanced computed tomography with rectal contrast administration provided the decisive information. In addition to sigmoid diverticulitis (fat stranding/centipede sign) in the urographic phase, contrast media was well traceable intraluminally from the bladder through the bladder wall abscess and subsequently in the sigmoid colon.
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