[Incidence, diagnosis and treatment of colovesical fistula].
BACKGROUND
Enterovesical fistula, also known as vesicoenteric fistula, is an abnormal communication of the vesical bladder with a segment of the digestive tract. We undertook this study to describe diagnostic and therapeutic methods to treat colovesical fistula (CVF) in patients who attended the Coloproctology Unit of the Gastroenterology Service of the General Hospital in Mexico City.


METHODS
This is a descriptive study in CVF patients carried out from January 2001 to June 2006; descriptive statistics were used for analysis of information.


RESULTS
Eleven patients were identified (10 males and 1 female). Average age was 54.72 years (range: 39-73 years). Time from onset of symptoms to diagnosis was on average 11.9 months. The most frequent signs and symptoms were fecaluria, pneumaturia, dysuria, hematuria and chronic abdominal pain in hypogastric and left iliac regions. Nine patients were submitted to sigmoidectomy and primary colorectal anastomosis. Hartmann procedure was carried out in one patient with restoration of intestinal transit 6 weeks later. In one patient, a loop colostomy was built as a first operation, with sigmoidectomy with fistula resection as a second operation, and restoration of intestinal transit as the third.


CONCLUSIONS
Surgery is the only treatment that assures cure and avoids relapses. Sigmoidectomy and primary anastomosis must be considered as the treatment of choice. Mortality, although low, continues being a negative factor when surgery is indicated in these patients.
Charúa-Guindic
Luis
L
Académico de número, Academia Mexicana de Cirugía, Jefe de la Universidad de Coloproctología, Servicio de Gastroenterología, Hospital General de México, Facultad de Medicina, Universidad Nacional Autónoma de México. luischarua@yahoo.com
Jiménez-Bobadilla
Billy
B
Reveles-González
Alejandro
A
Avendaño-Espinosa
Octavio
O
Charúa-Levy
Elias
E
D000328:Adult; D000368:Aged; D003108:Colonic Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D001747:Urinary Bladder Fistula / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*