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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

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The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
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Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

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Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
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Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Enterovesical fistula caused by a toothpick.

Flavia Tombolini1, Vito Lacetera1, Giovanni Muzzonigro1

  • 1Department of Urology, Regional Hospital of Marche Region "Ospedali Riuniti Umberto I, Lancisi, Salesi", Ancona, Italy.

Case Reports in Urology
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Summary

A rare case of enterovesical fistula caused by an ingested toothpick was successfully treated with laparoscopic surgery. This minimally invasive approach removed the foreign body and resolved symptoms like pneumaturia and fecaluria.

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Area of Science:

  • Urology
  • Gastroenterology
  • Surgical Innovation

Background:

  • Enterovesical fistula is an abnormal connection between the bladder and the bowel, often presenting with urinary and fecal symptoms.
  • Accidental foreign body ingestion is an uncommon cause of enterovesical fistula, posing diagnostic and therapeutic challenges.

Purpose of the Study:

  • To report a unique case of enterovesical fistula secondary to a long-retained foreign body.
  • To highlight the diagnostic difficulties and the successful surgical management of this rare condition.

Main Methods:

  • A 23-year-old male presented with pneumaturia, fecaluria, and abdominal pain.
  • Initial investigations including cystoscopy, cystography, and colonoscopy were inconclusive.
  • Computed tomography (CT) identified a toothpick-induced fistula between the sigmoid colon and bladder.

Main Results:

  • Endoscopic removal attempts via cystoscopy and colonoscopy failed.
  • Laparoscopic segmental resection of the sigmoid colon successfully removed the foreign body and fistula.
  • Post-operative cystography confirmed complete resolution without bladder leakage.

Conclusions:

  • Laparoscopic surgery is an effective treatment for enterovesical fistula caused by foreign bodies when endoscopic methods fail.
  • CT imaging is crucial for diagnosing obscure enterovesical fistulas.
  • Delayed presentation of foreign body complications necessitates a high index of suspicion.