Scientific paperThe spectrum of colovesical fistula and diagnostic paradigm
Section snippets
Materials and methods
Twelve male patients with the diagnosis of CVF were identified in our computer database over the period ranging from 1992 to 2004 at the McGuire Veterans Affairs Medical Center. The medical records of these patients were reviewed retrospectively and demographic, diagnostic, surgical treatment, and follow-up information were collected. Presenting symptoms were also recorded and reviewed. Preoperative evaluation of the patients included a multitude of invasive and noninvasive modalities,
Results
The average age at presentation of CVF was 63.9 years (range 46 to 83). All patients were male. The etiology of CVF was due to diverticulitis in the majority of patients (n = 9, 75%), followed by colon cancer (n = 2, 16%), and bladder cancer (n = 1, 8%). Other comorbidities noted in the reviewed cases included coronary artery disease (n = 3), hypertension (n = 6), and diabetes (n = 1). The most common presenting symptoms were pneumaturia (n = 7, 77%), urinary tract infections, dysuria and/or
Comments
CVF is an abnormal internal connection between the bladder and a portion of the large intestine, usually the sigmoid colon. The pathognomonic findings are terminal pneumaturia (the passage of air bubbles during urination) and fecaluria. Although the vast majority of patients ultimately diagnosed as having CVF present with one or both of these clinical findings, as we observed in our study, less specific findings such as urinary tract infections, dysuria, urinary frequency, and hematuria, or a
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2021, American Journal of Emergency MedicineCitation Excerpt :The underlying pathology may be due to diverticula disease, carcinoma, inflammatory bowel disease such as Crohn's Disease, congenital abnormality and trauma –with diverticulitis and carcinoma as the most common causes [1,3-5]. Common presenting symptoms include pneumaturia, urinary tract infections, fecaluria, hematuria, and orchitis [4]. Pneumaturia and fecaluria are pathognomonic for CVF [5].