title: Management of colovesical fistulae caused by diverticulitis: 12 years of experience in one medical centre.
abstract: BACKGROUND
  Diverticulitis can be complicated by a colovesical fistula (CVF). This phenomenon is relatively uncommon in surgical practice. The aim of this study was to evaluate diagnostic and surgical management of CVF at our medical centre.
  
  
  METHODS
  In this retrospective study, details of 31 patients undergoing surgery for CVF between January 1998 and March 2010 were recorded. These patient records were analysed for presenting symptoms, diagnostic investigations and surgical procedures.
  
  
  RESULTS
  The most common presenting symptoms were pneumaturia, urinary tract infections, abdominal pain, and fecaluria. CT identified CVF in 28 patients (92.2%), cystoscopy in 4 patients (23.5%), and barium enema in 3 patients (13.6%). Surgical management was resection of the diseased colon segment with primary anastomosis in 29 of 31 patients. The bladder fistulae were oversewn and an omental plasty was placed between bowel anastomosis and bladder. There was only one postoperative leak and one case of mortality (3.2%).
  
  
  CONCLUSIONS
  CT is the most sensitive test in identifying CVF. Resection of the diseased colon segment and primary anastomosis seems to be an effective and safe surgical method for treating CVF. This surgical treatment has an acceptable risk for anastomotic leak and mortality.
authors.affiliation: Department of Surgery, Deventer Hospital, the Netherlands. maartengjn@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Niebling
authors.forename: L
authors.initials: L
authors.lastname: van Nunspeet
authors.forename: H
authors.initials: H
authors.lastname: Zwaving
authors.forename: E H
authors.initials: EH
authors.lastname: Eddes
authors.forename: R
authors.initials: R
authors.lastname: Bosker
authors.forename: M
authors.initials: M
authors.lastname: Eeftinck Schattenkerk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004239:Diverticulitis, Colonic / Q000150:complications*; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome