Vesico-diverticular fistula: a rare complication of Meckel's diverticulum.
Enterovesical fistulas usually result from diverticulitis, Crohn's disease, or colorectal cancer. A perforated Meckel's diverticulum can also result in an vesico-diverticulum fistula, as noted in three previously reported cases. In all three cases, bladder or bowel disease was associated with the fistula. Herein, the authors describe a previously healthy, 23-year-old man who presented with an enterovesical fistula. Exploratory laparotomy revealed a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum. Pathologic examination revealed that the diverticulum did not contain ectopic gastric or pancreatic tissue and that the perforation was secondary to an enterolith. The patient underwent a diverticulectomy and had an uneventful postoperative course. Unlike any of the three previously reported cases, the authors' patient had no coexisting bowel or bladder disease occurring with his vesico-diverticular fistula. To the authors' knowledge, this is only the third reported case of a vesico-diverticular fistula resulting from a perforated Meckel's diverticulum that did not contain ectopic tissue. It represents the first case where the perforation was secondary to an enterolith.
Hudson
H M
HM
Department of Surgery, Boston University Medical Center, Massachusetts 02118.
Millham
F H
FH
Dennis
R
R
D000328:Adult; D001466:Barium Sulfate; D004733:Enema; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007416:Intestinal Perforation / Q000150:complications* / Q000196:embryology / Q000473:pathology; D008297:Male; D008467:Meckel Diverticulum / Q000150:complications* / Q000196:embryology / Q000473:pathology; D014057:Tomography, X-Ray Computed; D001747:Urinary Bladder Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery
D001466:Barium Sulfate