Colovesical fistula an unusual complication of cytotoxic therapy in a case of non-Hodgkin's lymphoma.
A 65-year old man, a known case of non-Hodgkin's lymphoma of base of the tongue and epiglottis presented with complaints of pneumaturia and faecaluria. He had received the first cycle of cytotoxic therapy (CHOP-regimen). At the end of the cycle he developed febrile neutropenia (circulating granulocyte count <1500/mm3). Cystogram showed air in the bladder area and a fistulous communication to a cavity behind the bladder. CT-scan showed air in the bladder, a fistulous communication between the sigmoid colon and bladder along with an intervening small abscess cavity. On exploration a fistulous communication between the sigmoid and bladder along with an intervening small abscess cavity was found. Resection of involved portion of sigmoid and end to end anastomosis along with a diverting colostomy was done. The bladder was closed in two layers with an omental interposition between it and the sigmoid along with a suprapubic cystostomy. The histopathology demonstrated only inflammatory response without any evidence of malignancy or diverticular disease.
Ansari
M S
MS
Department of Urology and Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi.
Nabi
G
G
Singh
I
I
Hemal
A K
AK
Pandey
G
G
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000009:adverse effects* / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects* / Q000627:therapeutic use; D004825:Epiglottis; D006801:Humans; D007412:Intestinal Fistula / Q000139:chemically induced*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D012810:Sigmoid Diseases / Q000139:chemically induced*; D014062:Tongue Neoplasms / Q000188:drug therapy*; D001747:Urinary Bladder Fistula / Q000139:chemically induced*; D014750:Vincristine / Q000009:adverse effects* / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone