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Colovesical fistula in sigmoid diverticulitis. A case report
Annali Italiani Di Chirurgia
|August 7, 2013
Summary
Diverticular disease can cause colovesical fistulas, leading to symptoms like pneumaturia and fecaluria. Surgical intervention for sigmoid diverticulitis-induced colovesical fistula resulted in successful patient recovery and no recurrence.
Area of Science:
- Gastroenterology
- Urology
- Surgical Oncology
Background:
- Colonic diverticulosis is increasing, with a notable rise in left-sided disease.
- Colovesical fistula, an uncommon complication of diverticulitis, is most frequently caused by diverticular disease.
- Pneumaturia and fecaluria are characteristic symptoms associated with colovesical fistulas.
Observation:
- A 79-year-old woman presented with pneumaturia and fecaluria.
- Abdominal CT confirmed a colovesical fistula secondary to sigmoid diverticulitis.
- The patient underwent surgical adhesiolysis, bladder wall repair, and segmental colonic resection.
Findings:
- The surgical approach involved adhesiolysis between the sigmoid colon and bladder, followed by simple closure of the bladder defect.
- Segmental resection of the colon, including the rectosigmoid junction, addressed the colonic defect.
- Post-operative follow-up at 6, 12, and 18 months showed continuous improvement without recurrence.
Implications:
- This case highlights the successful surgical management of a colovesical fistula caused by sigmoid diverticulitis.
- Prompt diagnosis and surgical intervention are crucial for favorable outcomes in patients with colovesical fistulas.
- Effective treatment can lead to long-term resolution of symptoms and prevent disease recurrence.
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