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[Vesicoappendiceal Fistula: A Case Report].

Makoto Isono¹, Keiichi Ito¹, Masahiro Takahashi¹

¹The Department of Urology, National Defense Medical College.

Hinyokika Kiyo. Acta Urologica Japonica

|August 18, 2015

Summary

A man experienced food in urine due to a rare vesicoappendiceal fistula. Surgical intervention confirmed the connection between the bladder and appendix, resolving the urinary tract infection symptoms.

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Area of Science:

Gastroenterology
Urology
Surgical Pathology

Background:

A 65-year-old male presented with a two-year history of intermittent food particles in urine, followed by acute symptoms of fever and cloudy urine.
Initial diagnosis was urinary tract infection, but the presence of fecaluria (feces in urine) suggested a gastrointestinal-urinary tract fistula.

Observation:

Diagnostic imaging, including cystography, revealed an unusual outflow of contrast media into the appendix.
Cystoscopy confirmed a fistula on the posterior bladder wall with visible fecal matter entering the bladder.

Findings:

Surgical exploration diagnosed a vesicoappendiceal fistula, an abnormal connection between the urinary bladder and the appendix.
The appendix was adhered to the ileum, bladder, and rectum, indicating extensive inflammation and likely abscess formation that perforated into the bladder.

Implications:

This case highlights the importance of investigating persistent urinary tract infections with unusual symptoms for underlying fistulous connections.
Prompt surgical resection of the involved structures (appendix, bladder segment) is crucial for resolving symptoms and preventing complications associated with vesicoappendiceal fistulas.