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Colovesical fistula resulting from a perforated colonic duplication
R M Decter1, K M Kaplan, K D Eggli
1Department of Surgery, Pennsylvania State University College of Medicine, Hershey 17033, USA.
Insights
Colovesical fistulas in children are rare and usually linked to anorectal malformations. This case highlights an acquired colovesical fistula resulting from a colonic duplication abscess, a unique cause in pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Urology
Background:
- Colovesical fistulas in children are predominantly congenital, often linked to high anorectal imperforations.
- Acquired enterovesical fistulas in pediatric populations are infrequently associated with inflammatory conditions.
Observation:
- A child presented with fever of unknown origin, prompting further investigation.
- Imaging and clinical evaluation revealed an acquired colovesical fistula.
Findings:
- The fistula was found to be caused by the erosion of an abscess.
- The abscess originated from the distal end of a colonic duplication, an uncommon etiology.
Implications:
- This case expands the differential diagnosis for acquired colovesical fistulas in children.
- Highlights the importance of considering rare congenital anomalies like colonic duplications in acquired fistulas.
- Suggests a need for thorough evaluation in pediatric cases of unexplained fever and urinary symptoms.
Abstract:
Colovesical fistulas in children are most often associated with high anorectal imperforations. Acquired enterovesical fistulas in children only rarely have been reported as a consequence of an inflammatory process. We present a case of an acquired colovesical fistula formed by the erosion of an abscess at the distal end of a colonic duplication in a child who presented with fever of unknown origin.