[Appendicovesical fistula treated with elective laparoscopic surgery]

Area of Science:

• Urology
• Gastroenterology
• Surgical Innovation

Background:

• Appendicovesical fistula is a rare complication of advanced acute appendicitis, presenting with vague symptoms.
• Diagnosis is challenging, often requiring a high index of suspicion and historically relying on exploratory laparotomy.
• Enterovesical fistulas, including appendicovesical fistulas, are uncommon conditions.

Observation:

• A case of appendicovesical fistula in a 45-year-old female with persistent dysuria and pyuria is presented.
• The patient was diagnosed using computerized tomography (CT) scan.
• This case represents one of 116 reported cases and one of only four treated laparoscopically.

Findings:

• Conventional imaging methods are often unreliable for diagnosing enterovesical fistulas.
• Computerized tomography is the preferred diagnostic modality when a digestive tract-urinary tract communication is suspected.
• Laparoscopic surgery can confirm radiological diagnosis and provide definitive treatment for appendicovesical fistula.

Implications:

• The study highlights the diagnostic and therapeutic value of computerized tomography and laparoscopy in managing appendicovesical fistulas.
• Laparoscopic approach is emerging as a viable alternative to traditional laparotomy for both diagnosis and treatment.
• Increased awareness and utilization of advanced imaging and minimally invasive techniques can improve patient outcomes.