Enterovesical fistulas are not uncommon in patients with inflammatory or malignant colonic disease, however, fistulas secondary to primary bladder carcinomas are extremely rare. We herein reported a patient presenting...Enterovesical fistulas are not uncommon in patients with inflammatory or malignant colonic disease, however, fistulas secondary to primary bladder carcinomas are extremely rare. We herein reported a patient presenting with intractable urinary tract infection due to enterovesical fistula formation caused by a squamous cell carcinoma of the urinary bladder. This patient underwent en bloc resection of the bladder dome and involved ileum, and recovered uneventfully without urinary complaint. To the best of our knowledge, this is the first case reported in the literature.展开更多
Background: Enterovesical fistula is an abnormal communication between the bladder and the gastrointestinal tract. It is an uncommon type of genital fistula, occasionally complicating pelvic surgeries. However, it is ...Background: Enterovesical fistula is an abnormal communication between the bladder and the gastrointestinal tract. It is an uncommon type of genital fistula, occasionally complicating pelvic surgeries. However, it is the most common type of fistula associated with diverticular disease of the colon. Other causes include cancer, trauma and iatrogenic injuries. Pneumaturia and fecaluria usually implies enterovesical fistula. Enterovesical fistula complicating myomectomy is an uncommon finding. Our aim is to report a case of enterovesical fistula following myomectomy. Case presentation: She is a 33-year-old nullipara who presented at the National Obstetric Fistula Centre, Abakaliki, Ebonyi State, South-Eastern Nigeria with a history of fecaluria, pneumaturia and haematochezia which started after myomectomy. Feculent fluid was obtained on urethral catheterization. Cystography was suggestive of enterovesical fistula. Conclusion: Enterovesical fistula is a possible complication of myomectomy. A high index of suspicion for this rare but potentially devastating condition is important for early diagnosis and appropriate management.展开更多
Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle ...Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle invasive urothelial carcinoma of bladder with an enterovesical fistula to a loop of small bowel. The patient first presented with signs and symptoms of per rectal bleeding,haematuria,pneumaturia,faecaluria and rectal micturition. Her initial biochemistry test revealed significant metabolic acidosis with normal anion gap and hypokalemia. A computed tomography abdomen/pelvis with rectal contrast demonstrated an enterovesical fistula from the dome of bladder to a loop of small bowel. The patient underwent radical cystectomy with enbloc resection of a loop of involved ileum and sigmoid colon due to the intraoperative findings of the sigmoid colon adherent to the tumour. The published literature is reviewed,focusing on the incidence,diagnostic modality and treatment strategies available for this rare condition.展开更多
Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical practice.They are a heterogeneous group of pathological entities that are uncommon complicat...Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical practice.They are a heterogeneous group of pathological entities that are uncommon complications of both benign and malignant processes.As the incidence of complicated diverticular disease and colorectal malignancy increases,so too does the extent of fistulous connections between the gastrointestinal and urinary systems.These complex problems will be more common as a factor of an aging population with increased life expectancy.Diverticular disease is the most commonly encountered aetiology,accounting for up to 80%of cases,followed by colorectal malignancy in up to 20%.A high index of suspicion is required in order to make the diagnosis,with ever improving imaging techniques playing an important role in the diagnostic algorithm.Management strategies vary,with most surgeons now advocating for a single-stage approach to enterovesical fistulae,particularly in the elective setting.Concomitant bladder management techniques are also disputed.Traditionally,open techniques were the standard;however,increased experience and advances in surgical technology have contributed to refined and improved laparoscopic management.Unfortunately,due to the relative rarity of these entities,no randomised studies have been performed to ascertain the most appropriate management strategy.Rectourinary fistulae have dramatically increased in incidence with advances in the non-operative management of prostate cancer.With radiotherapy being a major contributing factor in the development of these complex fistulae,optimum surgical approach and exposure has changed accordingly to optimise their management.Conservative management in the form of diversion therapy is effective in temporising the situation and allowing for the diversion of faecal contents if there is associated soiling,macerated tissues or associated co-morbidities.One may plan for definitive surgical intervention at a later stage.Less contaminated cases with no fibrosis may proceed directly to definitive surgery if the appropriate expertise is available.An abdominal approach with direct repair and omentum interposition between the repaired tissues has been well described.In low lying fistulae,a transperineal approach with the patient in a prone-jack knife position provides optimum exposure and allows for the use of interposition muscle grafts.According to recent literature,it offers a high success rate in complex cases.展开更多
BACKGROUND Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic.To our knowledge,no more than 4 cases of appendico-vesic...BACKGROUND Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic.To our knowledge,no more than 4 cases of appendico-vesicocolonic fistulas have been publicly reported throughout the world,and no more than 100 cases of appendiceal-colonic fistulas have been reported.Although the overall incidence is low,an early diagnosis is difficult due to their atypical initial symptoms,but these diseases still require our attention.CASE SUMMARY Here,we report a case of a 77-year-old male patient diagnosed with an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula.The main manifestations were diarrhea and urine that contained fecal material.The diagnosis was confirmed by multiple laboratory and imaging examinations.A routine urinalysis showed red blood cells and white blood cells.Abdominal and pelvic computed tomography scans showed close adhesions between the bowels and the bladder,and fistulas could be seen.Colonoscopy and cystoscopy and some other imaging examinations clearly showed fistulas.The preoperative diagnoses were a colovesical fistula and an appendiceal-colonic fistula.The fistulas were repaired by laparoscopic surgical treatment.The diseased bowel and part of the bladder wall were removed,followed by a protective ileostomy.The postoperative diagnosis was an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula,and the pathology suggested inflammatory changes.The patient recovered well after surgery,and all his symptoms resolved.CONCLUSION The final diagnosis in this case was a double fistula consisting of an appendicovesicocolonic fistula combined with an appendiceal-colonic fistula.展开更多
文摘Enterovesical fistulas are not uncommon in patients with inflammatory or malignant colonic disease, however, fistulas secondary to primary bladder carcinomas are extremely rare. We herein reported a patient presenting with intractable urinary tract infection due to enterovesical fistula formation caused by a squamous cell carcinoma of the urinary bladder. This patient underwent en bloc resection of the bladder dome and involved ileum, and recovered uneventfully without urinary complaint. To the best of our knowledge, this is the first case reported in the literature.
文摘Background: Enterovesical fistula is an abnormal communication between the bladder and the gastrointestinal tract. It is an uncommon type of genital fistula, occasionally complicating pelvic surgeries. However, it is the most common type of fistula associated with diverticular disease of the colon. Other causes include cancer, trauma and iatrogenic injuries. Pneumaturia and fecaluria usually implies enterovesical fistula. Enterovesical fistula complicating myomectomy is an uncommon finding. Our aim is to report a case of enterovesical fistula following myomectomy. Case presentation: She is a 33-year-old nullipara who presented at the National Obstetric Fistula Centre, Abakaliki, Ebonyi State, South-Eastern Nigeria with a history of fecaluria, pneumaturia and haematochezia which started after myomectomy. Feculent fluid was obtained on urethral catheterization. Cystography was suggestive of enterovesical fistula. Conclusion: Enterovesical fistula is a possible complication of myomectomy. A high index of suspicion for this rare but potentially devastating condition is important for early diagnosis and appropriate management.
文摘Enterovesical fistulae secondary to benign or malignant bowel disease are not uncommonly reported in the literature. However,bladder malignancy as the primary pathology is exceedingly rare. We report a case of muscle invasive urothelial carcinoma of bladder with an enterovesical fistula to a loop of small bowel. The patient first presented with signs and symptoms of per rectal bleeding,haematuria,pneumaturia,faecaluria and rectal micturition. Her initial biochemistry test revealed significant metabolic acidosis with normal anion gap and hypokalemia. A computed tomography abdomen/pelvis with rectal contrast demonstrated an enterovesical fistula from the dome of bladder to a loop of small bowel. The patient underwent radical cystectomy with enbloc resection of a loop of involved ileum and sigmoid colon due to the intraoperative findings of the sigmoid colon adherent to the tumour. The published literature is reviewed,focusing on the incidence,diagnostic modality and treatment strategies available for this rare condition.
文摘Fistulae between the gastrointestinal and urinary systems are rare but becoming increasingly more common in current surgical practice.They are a heterogeneous group of pathological entities that are uncommon complications of both benign and malignant processes.As the incidence of complicated diverticular disease and colorectal malignancy increases,so too does the extent of fistulous connections between the gastrointestinal and urinary systems.These complex problems will be more common as a factor of an aging population with increased life expectancy.Diverticular disease is the most commonly encountered aetiology,accounting for up to 80%of cases,followed by colorectal malignancy in up to 20%.A high index of suspicion is required in order to make the diagnosis,with ever improving imaging techniques playing an important role in the diagnostic algorithm.Management strategies vary,with most surgeons now advocating for a single-stage approach to enterovesical fistulae,particularly in the elective setting.Concomitant bladder management techniques are also disputed.Traditionally,open techniques were the standard;however,increased experience and advances in surgical technology have contributed to refined and improved laparoscopic management.Unfortunately,due to the relative rarity of these entities,no randomised studies have been performed to ascertain the most appropriate management strategy.Rectourinary fistulae have dramatically increased in incidence with advances in the non-operative management of prostate cancer.With radiotherapy being a major contributing factor in the development of these complex fistulae,optimum surgical approach and exposure has changed accordingly to optimise their management.Conservative management in the form of diversion therapy is effective in temporising the situation and allowing for the diversion of faecal contents if there is associated soiling,macerated tissues or associated co-morbidities.One may plan for definitive surgical intervention at a later stage.Less contaminated cases with no fibrosis may proceed directly to definitive surgery if the appropriate expertise is available.An abdominal approach with direct repair and omentum interposition between the repaired tissues has been well described.In low lying fistulae,a transperineal approach with the patient in a prone-jack knife position provides optimum exposure and allows for the use of interposition muscle grafts.According to recent literature,it offers a high success rate in complex cases.
文摘BACKGROUND Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic.To our knowledge,no more than 4 cases of appendico-vesicocolonic fistulas have been publicly reported throughout the world,and no more than 100 cases of appendiceal-colonic fistulas have been reported.Although the overall incidence is low,an early diagnosis is difficult due to their atypical initial symptoms,but these diseases still require our attention.CASE SUMMARY Here,we report a case of a 77-year-old male patient diagnosed with an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula.The main manifestations were diarrhea and urine that contained fecal material.The diagnosis was confirmed by multiple laboratory and imaging examinations.A routine urinalysis showed red blood cells and white blood cells.Abdominal and pelvic computed tomography scans showed close adhesions between the bowels and the bladder,and fistulas could be seen.Colonoscopy and cystoscopy and some other imaging examinations clearly showed fistulas.The preoperative diagnoses were a colovesical fistula and an appendiceal-colonic fistula.The fistulas were repaired by laparoscopic surgical treatment.The diseased bowel and part of the bladder wall were removed,followed by a protective ileostomy.The postoperative diagnosis was an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula,and the pathology suggested inflammatory changes.The patient recovered well after surgery,and all his symptoms resolved.CONCLUSION The final diagnosis in this case was a double fistula consisting of an appendicovesicocolonic fistula combined with an appendiceal-colonic fistula.
