The spectrum of colovesical fistula and diagnostic paradigm
| Autor: | Thomas A. Miller, Mohammad K. Jamal, Jeannie F. Savas, Samer F. Najjar |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
medicine.medical_specialty Risk Assessment Severity of Illness Index Sampling Studies Cystography Colonic Diseases Fecaluria Intestinal Fistula Medicine Dysuria Humans Barium enema Aged Retrospective Studies Aged 80 and over Pneumaturia medicine.diagnostic_test business.industry Urinary Bladder Fistula General Medicine Cystoscopy Colonoscopy Diverticulitis Middle Aged medicine.disease Surgery Treatment Outcome Diverticular disease Radiology medicine.symptom business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | American journal of surgery. 188(5) |
| ISSN: | 0002-9610 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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