[Vesico-sigmoidal fistulas. Evaluation of the diagnostic performance of the complementary tests in our series].
We analyzed 14 cases of colovesical fistula that had been diagnosed and treated at the urology and gastroenterology and general surgery services of our hospital from 1986-1990. In 85.7% of the cases, the fistula had been caused by a tumor (adenocarcinoma of the colon) and in 14.3% by inflammatory disease (diverticulitis of the colon). All patients presented a varying degree of micturition syndrome; 30% had pneumaturia and 40% fecaluria. Cystoscopy proved to be the most effective in diagnosing colovesical fistula. It permitted visualization of the fistula or passage of fecal material to the bladder in 33% of the cases, while indirect endoscopic signs could be observed in 100%. Furthermore, it permitted the anatomopathological diagnosis of adenocarcinoma of the colon in 5 cases. We performed one-stage en bloc radical surgery in 57% of the cases, shotgun barrel discharge colostomy in 2 cases, exploration laparotomy in 3 and treatment was withheld in 1 case. The overall survival for the group submitted to radical surgery was 19.5 +/- 8.0 months. There were 4 deaths from metastasis, 2 from sepsis originating in the abdomen and the remaining deaths were due to iliofemoral venous thrombosis, cardiovascular disease and pneumopathy.
Vesa Llanés
J
J
Servicio de Urología, Hospital Universitario del Mar, Facultad de Medicina, Universidad Autónoma de Barcelona, España.
Lladó Carbonell
C
C
Valverde Sintas
J
J
Bielsa Gali
O
O
Arango Toro
O
O
Gelabert Mas
A
A
D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003110:Colonic Neoplasms / Q000150:complications; D004238:Diverticulitis / Q000150:complications; D004724:Endoscopy; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016482:Urinalysis; D001747:Urinary Bladder Fistula / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D014567:Urography
Fístulas vésico-sigmoideas. Valoración del rendimiento diagnóstico de las pruebas complementarias en nuestra serie.