title: Diagnostic lessons learnt from a series of enterovesical fistulae.
abstract: OBJECTIVE
  An enterovesical fistula (EVF) is an uncommon condition requiring careful and sometimes extensive preoperative investigation. Our experience over a 10-year period has been reviewed with emphasis on the diagnostic investigations performed.
  
  
  METHODS
  Forty-two patients (30 male) have been studied. Presenting symptoms, diagnostic investigations, and subsequent treatment have been reviewed.
  
  
  RESULTS
  The site of the fistulae were; 37 colonic, 2 rectal, and 3 ileal. The commonest presenting symptoms were; pneumaturia 75%, faecaluria 63% and urinary tract infections 57%. The positivity rate of the investigations performed were; cystoscopy 89%, urine cytology 86%, barium enema 65%, computerized tomography (CT) scanning 55%, IVP 35%, and cystography 27.5%. The causes of the fistula were; diverticular disease 71%, carcinoma 20%, Crohn's disease 7%, and radiotherapy 2%.
  
  
  CONCLUSIONS
  We recommend cystoscopy and urine cytology for faecal material as the first-line investigations in all patients with a suspected enterovesical fistulae. CT scanning and barium enema should not be first line investigations but may be performed subsequently to help determine the aetiology and planning of surgery.
authors.affiliation: Department of Surgery, St Peter's Hospital, Chertsey, UK. irdaniels@dorkingrh4.freeserve.co.uk
authors.forename: I R
authors.initials: IR
authors.lastname: Daniels
authors.forename: B
authors.initials: B
authors.lastname: Bekdash
authors.forename: H J
authors.initials: HJ
authors.lastname: Scott
authors.forename: C G
authors.initials: CG
authors.lastname: Marks
authors.forename: D R
authors.initials: DR
authors.lastname: Donaldson