Vesicointestinal fistula explained

Vesicointestinal fistula
Synonyms:	Intestinovesical 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"^{[1] [2]}
• 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.^[3]

Causes

Many causes exist including:^[4]

• diverticulitis : most common ~ 60%
• colorectal cancer (CRC) : ~ 20%
• Crohn's disease : ~ 10%
• radiotherapy
• appendicitis
• trauma

Diagnosis

Various modalities of diagnosis are available:^[5]

• Cystoscopy
• Colonoscopy
• Poppy seed test^[6]
• Transabdominal ultrasonography
• Abdominopelvic CT
• MRI
• Barium enema
• Bourne test^[7]
• Cystogram

A definite algorithm of tests is followed for making the diagnosis.

See also

• Gouverneur’s syndrome

Notes and References

1. Merck Geriatrics 14-118f
2. Web site: Fistula enterovesical. https://archive.today/20120204093114/http://www.medcyclopaedia.com/library/topics/volume_iv_2/f/fistula_enterovesical.aspx. dead. 2012-02-04. GE. Medcyclopaedia.
3. Web site: Weerakkody. Yuranga. Colovesical Fistula. Radiopaedia.org. 13 September 2014. Gaillard, Frank.
4. Web site: Weerakkody. Yuranga. Colovesical Fistula. Radiopaedia.org. 13 September 2014. Gaillard, Frank.
5. Golabek. Tomasz. Szymanska, Anna . Szopinski, Tomasz . Bukowczan, Jakub . Furmanek, Mariusz . Powroznik, Jan . Chlosta, Piotr . Enterovesical Fistulae: Aetiology, Imaging, and Management. Gastroenterology Research and Practice. 2013. 2013. 1–8. 10.1155/2013/617967. 24348538. 3857900. Fig.1. free .
6. Kwon. EO. Armenakas, NA . Scharf, SC . Panagopoulos, G . Fracchia, JA . The poppy seed test for colovesical fistula: big bang, little bucks!. The Journal of Urology. Apr 2008. 179. 4. 1425–7. 10.1016/j.juro.2007.11.085. 18289575.
7. Amendola. MA. Agha, FP . Dent, TL . Amendola, BE . Shirazi, KK . Detection of occult colovesical fistula by the Bourne test.. AJR. American Journal of Roentgenology. Apr 1984. 142. 4. 715–8. 10.2214/ajr.142.4.715. 6608228.