title: Ten Cases of Colovesical Fistula due to Sigmoid Diverticulitis.
abstract: Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%). The abilities of various preoperative investigations to identify CVF were: computed tomography (CT), 88.9%; magnetic resonance imaging, 40%; cystoscopy, 30%, and gastrografin irrigoscopy, 22.2%. Colonoscopy (0%) was not diagnostic. Bowel resection was performed in nine of ten patients. When inflammation was intense, covering ileostomy was performed, and an omental plasty was placed between the bowel anastomosis and bladder. When CVF is suspected, we recommend CT followed by colonoscopy and cystoscopy as a first-line investigation to rule out malignancy as a cause. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. Primary colic anastomosis appears to be safely performed by applying omental plasty and covering ileostomy.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyaso
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Iwakawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hamada
authors.forename: Nanako
authors.initials: N
authors.lastname: Yasui
authors.forename: Gou
authors.initials: G
authors.lastname: Nishii
authors.forename: Masaaki
authors.initials: M
authors.lastname: Akai
authors.forename: Kengo
authors.initials: K
authors.lastname: Kawada
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonoshita
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kajioka
authors.forename: Kenta
authors.initials: K
authors.lastname: Isoda
authors.forename: Kouji
authors.initials: K
authors.lastname: Kitada
authors.forename: Manabu
authors.initials: M
authors.lastname: Nishie
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Hamano
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Tokunaga
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tsunemitsu
authors.forename: Shinya
authors.initials: S
authors.lastname: Otsuka
authors.forename: Masaru
authors.initials: M
authors.lastname: Inagaki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Iwagaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003113:Colonoscopy; D003287:Contrast Media; D003558:Cystoscopy; D003974:Diatrizoate Meglumine; D004239:Diverticulitis, Colonic / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012810:Sigmoid Diseases / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine