The spectrum of colovesical fistula and diagnostic paradigm |
| |
Authors: | Najjar Samer F Jamal Mohammad K Savas Jeannie F Miller Thomas A |
| |
Affiliation: | Department of Surgery, Hunter Holmes McGuire Veterans Affairs Medical Center and Virginia Commonwealth University Medical Center, 1201 Broad Rock Blvd, Richmond, VA 23249, USA. |
| |
Abstract: | BACKGROUND: Our experience with colovesical fistula (CVF) over a 12-year period was reviewed to clarify its clinical presentation and diagnostic confirmation. METHODS: Twelve patients with CVF were identified. Presenting symptoms, etiologic factors, diagnostic investigations, and subsequent treatment were reviewed. RESULTS: Underlying etiologies were diverticular disease (75%), colon cancer (16%), and bladder cancer (8%). Pneumaturia (77%) was the most common presentation, followed by urinary tract infections, dysuria and frequency (45%), fecaluria (36%), hematuria (22%), and orchitis (10%). The ability of various preoperative investigations to identify a CVF were: computed tomography (CT) (90%), barium enema (BE) (20%), and cystography (11%), whereas cystoscopy, intravenous pyelogram (IVP), and colonoscopy were nondiagnostic. All patients underwent single- or multiple-staged repair of the fistula. CONCLUSIONS: In patients with a suspected CVF, we recommend CT followed by a colonoscopy as a first-line investigation to rule out malignancy as a cause of CVF. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. |
| |
Keywords: | Colovesical fistula Computed tomography Diverticulitis Colon cancer Pneumaturia |
本文献已被 ScienceDirect PubMed 等数据库收录! |
|