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Osteomyelitis secondary to an osteoenteric fistula
S P Petrou1, C M Gomes, M I O'Connor
1Department of Urology, Mayo Clinic Jacksonville, Florida 32224, USA.
Urology
|January 1, 1996
Summary
Pubic osteomyelitis is a rare complication after pelvic surgery, often mistaken for osteitis pubis. This case highlights infection secondary to a small-bowel fistula from cancer recurrence.
Area of Science:
- Urology
- Oncology
- Infectious Disease
Background:
- Pelvic surgery, particularly radical cystectomy for bladder cancer, carries risks of complications.
- Osteomyelitis of the symphysis pubis is a rare but serious post-operative complication.
- Differentiating pubic osteomyelitis from osteitis pubis can be diagnostically challenging.
Observation:
- A patient developed disabling pubic pain four months after radical cystectomy.
- The pain was refractory to conservative medical and antibiotic treatments.
- Imaging and clinical course suggested an underlying infectious process.
Findings:
- The patient's pubic pain was diagnosed as osteomyelitis of the symphysis pubis.
- The osteomyelitis was secondary to a small-bowel fistula.
- The fistula was precipitated by bladder cancer recurrence.
Implications:
- This case underscores the importance of considering rare infectious complications after pelvic surgery.
- Early recognition of pubic osteomyelitis secondary to fistulas is crucial for effective management.
- Cancer recurrence should be investigated in patients with refractory post-operative pelvic pain.