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Colovesical fistula.

S G Pollard, R Macfarlane, R Greatorex

    Annals of the Royal College of Surgeons of England
    |July 1, 1987
    PubMed
    Summary
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    Diverticular disease is the primary cause of colovesical fistulas. Single-stage resection is a safe and effective treatment for uncomplicated cases, offering good outcomes for patients with these complex gastrointestinal conditions.

    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Colorectal Surgery

    Background:

    • Colovesical fistula, an abnormal connection between the colon and bladder, presents a significant clinical challenge.
    • Etiologies vary, including diverticular disease, malignancy, and inflammatory conditions, necessitating accurate diagnosis and effective management strategies.

    Purpose of the Study:

    • To report the experience with 66 cases of colovesical fistula.
    • To identify the most common causes and effective diagnostic investigations.
    • To evaluate the safety and efficacy of single-stage resection for treatment.

    Main Methods:

    • Retrospective review of 66 patients diagnosed with colovesical fistula.
    • Analysis of etiological factors, diagnostic modalities (including barium enema), and surgical outcomes.

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  • Evaluation of treatment outcomes for single-stage resection versus other approaches.

    • Main Results:

    • Diverticular disease was the most frequent cause (71%), followed by malignancy, Crohn's disease, radiotherapy, appendicitis, and trauma.
    • Barium enema demonstrated 98% abnormality and visualized the fistula in 57% of cases, proving highly sensitive.
    • Thirty-two patients underwent single-stage resection with no mortality or significant morbidity.

    Conclusions:

    • Diverticular disease is the leading cause of colovesical fistula.
    • Barium enema is a sensitive diagnostic tool for colovesical fistulas.
    • Single-stage resection is a safe and effective treatment for uncomplicated colovesical fistulas, recommended for suitable patients.