Concealed enterovesical fistula associated with forgotten intra-abdominal haemostat and intravesical towel.
Introduction. Enterovesical fistula is rare and is often caused by bowel inflammatory diseases and tumours in the urinary bladder or the intestine with local infiltration of bowel or bladder, respectively. The fistula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fistula following abdominal hysterectomy. Investigations confirmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. The towel was removed at cystoscopy after which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fistula. Discussion. A typical presentation of enterovesical fistula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection after abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the first time and strict operation room standards and guidelines should always be followed.
Urology Unit, Department of Surgery, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria.
Ademola Alabi
AA
Popoola
Urology Unit, Department of Surgery, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria.
J O
JO
Bello
Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria.
G G
GG
Ezeoke
Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria.
K T
KT
Adeshina
Urology Unit, Department of Surgery, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria.
A
A
Fadimu