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Vesicocolonic fistulas in diverticulitis

A Krompier, R Howard, A Macewen

    The Journal of Urology
    |June 1, 1976
    PubMed
    Summary

    Diverticulitis can lead to serious vesicocolonic fistulas, often presenting with urological symptoms like pneumaturia. Early diagnosis and intervention in diverticular disease can prevent fistulas and improve patient outcomes.

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    Area of Science:

    • Gastroenterology
    • Urology
    • Surgical Oncology

    Background:

    • Diverticulitis commonly affects individuals in their fifth and sixth decades.
    • Vesicocolonic fistulas are a potential complication of diverticulitis.

    Observation:

    • A review of 12 patients with vesicocolonic fistulas secondary to diverticulitis was conducted.
    • Presentations were primarily urological, with pneumaturia in 10/12 and fecaluria in 5/12 patients.

    Findings:

    • Fistulization is a staged process; early identification can prevent complications.
    • Bladder irritation in older patients warrants suspicion for underlying diverticular disease.
    • Pneumaturia and fecaluria are key indicators of vesicocolonic fistulas.
    • Cystoscopy is a reliable diagnostic tool for identifying vesicocolonic fistulas.

    Implications:

    • Prompt diagnosis of diverticular disease in patients with bladder irritation is crucial.
    • Individualized surgical approaches, including primary resection or staged repair, yield good results.
    • Preventing fistulization significantly reduces morbidity and mortality rates associated with diverticulitis.

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