Post-operative Vesicoenterocutaneous Fistula with Multiple Intestinal Knotting: A Case Report

Area of Science:

• Urology
• Gastroenterology
• Surgical Case Report

Background:

• A 51-year-old male farmer with a history of open transvesical prostatectomy for benign prostate enlargement presented with recurrent urinary leakage.
• The patient underwent a second surgery for urinary leakage, which recurred, leading to feculent urine discharge from an abdominal wall scar.

Observation:

• Exploratory laparotomy revealed multiple, asymptomatic small bowel knotting and fistula tracts.
• The patient presented with a complex abdominal fistula involving the urinary tract and intestines.

Findings:

• Surgical intervention included manual unknotting of ileal loops, excision of fistula tracts, and end-to-end ileoileal anastomosis.
• Bladder repair was performed with a suprapubic cystostomy.

Implications:

• Timely management of the incidental small bowel knotting prevented potential diagnostic challenges and severe outcomes.
• This case highlights the importance of thorough surgical exploration in complex abdominal fistulas post-prostatectomy.