Vesicointestinal fistula

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Vesicointestinal fistula
Other names	Intestinovesical fistula
Specialty	Urology

A vesicointestinal fistula (or intestinovesical fistula) is a form of fistula between the bladder and the bowel.

Types

A fistula involving the bladder can have one of many specific names, describing the specific location of its outlet:

Bladder and intestine: "vesicoenteric", "enterovesical", or "vesicointestinal"^[1]^[2]^[3]
Bladder and colon: "vesicocolic" or "colovesical"^[4]
Bladder and rectum: "vesicorectal" or "rectovesical"^[5]

Symptoms and signs

If fecal matter passes through the fistula into the bladder, the existence of the fistula may be revealed by pneumaturia, fecaluria, or recurrent urinary tract infection. Migration of urine through the fistula into the bowel may cause rectal passage of urine.^[6]

Causes

Many causes exist including:^[6]

diverticulitis : most common ~ 60%
colorectal cancer (CRC) : ~ 20%
Crohn's disease : ~ 10%
radiotherapy
appendicitis
trauma

Diagnosis

Various modalities of diagnosis are available:^[7]

Cystoscopy
Colonoscopy
Poppy seed test^[8]
Transabdominal ultrasonography
Abdominopelvic CT
MRI
Barium enema
Bourne test^[9]
Cystogram

A definite algorithm of tests is followed for making the diagnosis.

References

^ Merck Geriatrics 14-118f
^ 11-149c. at Merck Manual of Diagnosis and Therapy Home Edition
^ "Fistula enterovesical". Medcyclopaedia. GE. Archived from the original on 2012-02-04.
^ "vesicocolic fistula". GPnotebook.
^ Diseases Database (DDB): 11193
^ ^a ^b Weerakkody, Yuranga; Gaillard, Frank. "Colovesical Fistula". Radiopaedia.org. Retrieved 13 September 2014.
^ Golabek, Tomasz; Szymanska, Anna; Szopinski, Tomasz; Bukowczan, Jakub; Furmanek, Mariusz; Powroznik, Jan; Chlosta, Piotr (2013). "Enterovesical Fistulae: Aetiology, Imaging, and Management". Gastroenterology Research and Practice. 2013: 1–8. doi:10.1155/2013/617967. PMC 3857900. PMID 24348538Fig.1{{cite journal}}: CS1 maint: postscript (link)
^ Kwon, EO; Armenakas, NA; Scharf, SC; Panagopoulos, G; Fracchia, JA (Apr 2008). "The poppy seed test for colovesical fistula: big bang, little bucks!". The Journal of Urology. 179 (4): 1425–7. doi:10.1016/j.juro.2007.11.085. PMID 18289575.
^ Amendola, MA; Agha, FP; Dent, TL; Amendola, BE; Shirazi, KK (Apr 1984). "Detection of occult colovesical fistula by the Bourne test". AJR. American Journal of Roentgenology. 142 (4): 715–8. doi:10.2214/ajr.142.4.715. PMID 6608228.

External links

Media related to Vesicointestinal fistula at Wikimedia Commons

v t e Diseases of the urinary tract
Ureter	Ureteritis Ureterocele Megaureter Ureteric stricture
Bladder	Cystitis Interstitial cystitis Hunner's ulcer Trigonitis Hemorrhagic cystitis Neurogenic bladder dysfunction Bladder sphincter dyssynergia Vesicointestinal fistula Vesicoureteral reflux
Urethra	Urethritis Non-gonococcal urethritis Urethral syndrome Urethral stricture Meatal stenosis Urethral caruncle
Any/all	Urologic chronic pelvic pain syndrome Obstructive uropathy Urinary tract infection Retroperitoneal fibrosis Urolithiasis Bladder stone Kidney stone Renal colic Malakoplakia Urinary incontinence Stress Urge Overflow

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Classification	D ICD-10: N32.1 ICD-9-CM: 596.1
External resources	eMedicine: med/2867 article/442000