[Fistulas in diverticular disease of the colon: study of 29 cases].
In analysing 29 patients with diverticular disease of the colon complicated by fistula, the authors encountered four types of fistula: colovesical, colovaginal, coloileal and colocutaneous. The commonest was the colovesical fistula (50%), which was diagnosed by the history and the suggestive cystoscopic findings. Colovaginal fistula was also suspected by the history and the presence of a pelvic mass in hysterectomized patients. Colocutaneous fistulas are demonstrated by fistulography whereas coloileal fistulas, which do not have clinical signs, are discovered only at operation. Surgical treatment, consisting of resection and anastomosis of the involved segment of the colon, is necessary. A one-stage procedure is usually feasible with little morbidity if the delay between the acute phase and the operation is longer than 3 months. When the operation is attempted sooner, the surgeon may have to use more than one stage with a longer period of disability and the possibility of more complications. Because the development of a fistula with diverticular disease seldom needs urgent surgical exploration, the authors recommend 3 months of conservative therapy after the acute phase to allow the local inflammatory reaction to subside so a one-stage operation can be performed.
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000209:etiology*; D004241:Diverticulum, Colon / Q000150:complications*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology; D007412:Intestinal Fistula / Q000209:etiology*; D007416:Intestinal Perforation / Q000150:complications; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000209:etiology; D001747:Urinary Bladder Fistula / Q000209:etiology; D014624:Vaginal Fistula / Q000209:etiology
Les fistules dans la maladie diverticulaire du côlon: étude de 29 cas.