title: [Appendicovesical fistula treated with elective laparoscopic surgery].
abstract: BACKGROUND
  appendicovesical fistula is a rare complication of advanced acute appendicitis and represents a rare type of enterovesical fistula. Its symptoms are vague and imprecise and its diagnosis is difficult, requiring a high level of suspicion. Exploratory laparotomy has been the key for diagnosis and definitive treatment for many years, but recently the laparoscopic approach is standing out among different experienced groups as the method of choice.
  
  
  METHODS
  we report a new case of appendicovesical fistula in a 45 year old female, who was remitted from Urology with symptoms of persistent dysuria and pyuria. She was finally diagnosed by computerized tomography and the appendicovesical fistula was resolved by laparoscopic surgery. This case adds to the one hundred and fifteen cases published so far and to the four treated by the laparoscopic approach.
  
  
  CONCLUSIONS
  conventional imaging methods are not reliable for the diagnosis of enterovesical fistula. Since most appendicovesical fistula are found to be secondary to non-diagnosed and advanced acute appendicitis in the majority of the consulted publications laparotomy is the key for the diagnosis of apendicovesical fistula. However laparoscopy is described as a diagnostic and therapeutic tool in few articles. We only found three articles in the literature referring to the laparoscopic approach as a therapeutic option.
  
  
  CONCLUSIONS
  computerized tomography is the diagnostic method of choice when communication between the digestive tract and urinary tract is suspected, particularly if the suspected fistula is an appendicovesical one. The laparoscopic approach of an appendicovesical fistula is able to confirm the radiological diagnosis and provide a definitive treatment.
authors: Servicio de Cirugía General y del Aparato Digestivo. Hospital Universitario de Fuenlabrada, Madrid, Spain. agarciamu.hflr@salud.madrid.org.
authors: Alejandro
authors: A
authors: García-Muñoz-Najar
authors: Servicio de Cirugía General y del Aparato Digestivo. Hospital Universitario de Fuenlabrada, Madrid, Spain.
authors: Lucía
authors: L
authors: Carrión-Álvarez
authors: Servicio de Cirugía General y del Aparato Digestivo. Hospital Universitario de Fuenlabrada, Madrid, Spain.
authors: Manuel
authors: M
authors: Medina-García
authors: Servicio de Diagnóstico por Imagen. Hospital Universitario de Fuenlabrada, Madrid, Spain.
authors: María Dolores
authors: MD
authors: García-González
authors: Servicio de Cirugía General y del Aparato Digestivo. Hospital Universitario de Fuenlabrada, Madrid, Spain.
authors: Fernando
authors: F
authors: Pereira-Pérez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001064:Appendicitis / Q000150:complications* / Q000601:surgery; D001943:Breast Neoplasms / Q000150:complications / Q000628:therapy; D002429:Cecal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000379:methods; D053159:Dysuria / Q000209:etiology; D017558:Elective Surgical Procedures; D005244:Fecal Impaction / Q000209:etiology; D005260:Female; D006801:Humans; D007412:Intestinal Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D001747:Urinary Bladder Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology
keywords: appendicitis; colovesical fistula; laparoscopia; laparoscopy