title: Colovesical fistula presenting with epididymitis.
abstract: This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew Enterococcus faecalis. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Subsequent CT imaging revealed air in the bladder and a colovesical fistula. The patient went on to have Hartmann's procedure with repair of the bladder defect. This case highlights that: (1) Colovesical fistulae may rarely present with epididymitis. (2) Colovesical fistulae are the most common cause of pneumaturia.
authors.affiliation: Department of Urology, Craigavon Area Hospital, Armagh, UK. marneill01@qub.ac.uk
authors.forename: Matthew
authors.initials: M
authors.lastname: Arneill
authors.forename: Derek Barry
authors.initials: DB
authors.lastname: Hennessey
authors.forename: Damian
authors.initials: D
authors.lastname: McKay
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004823:Epididymitis / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents