Vesicointestinal fistula
A vesicointestinal fistula (or intestinovesical fistula) is a form of fistula between the bladder and the bowel.

Types
A fistula involving the bladder can have one of many specific names, describing the specific location of its outlet:

Bladder and intestine: "vesicoenteric", "enterovesical", or "vesicointestinal"
Bladder and colon: "vesicocolic" or "colovesical"
Bladder and rectum: "vesicorectal" or "rectovesical"

Symptoms and signs
If fecal matter passes through the fistula into the bladder, the existence of the fistula may be revealed by pneumaturia, fecaluria, or recurrent urinary tract infection. Migration of urine through the fistula into the bowel may cause rectal passage of urine.

Causes
Many causes exist including:
diverticulitis : most common ~ 60%
colorectal cancer (CRC) : ~ 20%
Crohns disease : ~ 10%
radiotherapy
appendicitis
trauma

Diagnosis
Various modalities of diagnosis are available:
Cystoscopy
Colonoscopy
Poppy seed test
Transabdominal ultrasonography
Abdominopelvic CT
MRI
Barium enema
Bourne test
CystogramA definite algorithm of tests is followed for making the diagnosis.

See also
Gouverneur’s syndrome

References


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