Presentation
We present a patient with electrical burns which resulted in loss of the right upper arm and a urinary bladder fistula. A jump flap was used to cover the repaired bladder, and also to cover the stump of the amputated right arm. [ncbi.nlm.nih.gov]
In this review chapter, we cover the etiology, clinical presentation, and various surgical approaches to repairing vesicovaginal and enterovesical fistulas. [ucdavis.pure.elsevier.com]
He presented 7 months after initiation of ART, which suggests that this presentation was an IRIS phenomenon. IRIS in HIV-infected patients initiating ART results from restored immunity to specific infectious or non-infectious antigens. [sajs.redbricklibrary.com]
Our aim is to present a case of enterovesical fistula following myomectomy. 2. [scirp.org]
Most patients in the present series were male. [urotoday.com]
Entire Body System
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Recurrent Urinary Tract Infection
Presenting features include fecaluria, pneumaturia and recurrent urinary tract infection [5] [6] [7]. [scirp.org]
urinary tract infections, or passage of urine rectally 4. [radiopaedia.org]
The symptoms of the appendicovesical fistula resemble those of other enterovesical fistulae and include dysuria, recurrent urinary tract infection, pneumaturia, and fecaluria. Confirmation of the appendicular origin of such fistulae is difficult. [journals.lww.com]
Aggarwal, et al. (2011). “26-year-old man with recurrent urinary tract infections.” Mayo Clin Proc 86(6): 557-560. PubMed ; CrossRef Sou, S., T. Yao, et al. (1999). [urotoday.com]
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Bullet Wound
Even more rare situations are iatrogenic lesions after surgery [ 3, 16 - 19 ], and bullet wounds involving at the same time bowel and bladder [ 20, 21 ]. [omicsonline.org]
Respiratoric
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Rhinorrhea
[…] sometimes seen as a complication of empyema, fibrosis, or pneumonia. cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, such as from head trauma or bone erosion, with leakage of cerebrospinal fluid, usually in the form of rhinorrhea [medical-dictionary.thefreedictionary.com]
Gastrointestinal
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Abdominal Guarding
After the procedure, he suffered from sudden onset of abdominal guarding pain. [casereports.bmj.com]
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Polydipsia
Patients with complications of urinary diversions often appear acutely ill, with classic signs including easy fatigability, weakness, anorexia, polydipsia, and as seen in our patient, nausea, vomiting, and diarrhea. [consultant360.com]
Neurologic
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Tingling
He denied fever, chills, weight change, cough, dyspnea, chest pain, hematochezia, melena, dysuria, hematuria, urinary urgency, numbness, and tingling. History. [consultant360.com]
Urogenital
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Urinary Incontinence
A vesicovaginal fistula can lead to urinary incontinence and a rectovaginal fistula can lead to fecal incontinence. [search.com]
Urinary incontinence is a primary symptom of a bladder fistula, because the fistula's opening can leave you unable to control the flow of urine from the bladder. [sharecare.com]
Female Urinary Incontinence Male Urinary Incontinence Pelvic Organ Prolapse Urinary Tract Infection About our Incontinence Center Sexual Function & Infertility Epididymitis / Orchitis Erectile Dysfunction -Nonsurgical Management Erectile Dysfunction - [mciverclinic.com]
Causes of vesicovaginal fistula include iatrogenic, cervical or bladder carcinoma, obstetric injury, radiation, and foreign body; it presents clinically with continuous urinary incontinence. [med-ed.virginia.edu]
The classical Youssef's syndrome is characterized by menouria, absence of urinary incontinence, vesicouterine fistula and amenorrhoea despite a patent cervical canal. [ispub.com]
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Foul Smelling Urine
The symptoms usually encountered are: chronic urinary tract infections, gas bubbles during urination, bowel movements with urine in them, feces in the urine, foul smelling urine and a host of irrative bladder symptoms. [flinturology.com]
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Uremia
Due to its associated complications, including diarrhea, nephritis due to reflux of urine into the ureters, and uremia due to reabsorption of urea in the colon, it has become the least-performed procedure. [consultant360.com]
Workup
The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. [ncbi.nlm.nih.gov]
Discussion The diagnosis of an enterovesical fistula poses a significant challenge as there is no consensus on any clear gold standard for EVf workup. [omicsonline.org]
MRI may be useful in identifying deep perineal fistulae, but it is not generally used in the routine workup of colovesical fistulae. Diagnostic Procedures: Cystoscopy is an essential component of the diagnostic evaluation. [arabmedmag.com]
Other Pathologies
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Lymphocytic Infiltrate
Histologic examination of the appendix showed lymphocytic infiltration of the muscular and subserosal layers with small ulcerations and fissures, but no granulomas. The patient was discharged 5 days after surgery. [journals.lww.com]
Treatment
Following the diagnosis of a fistula, the medical professional will decide the best plan of treatment based on its location, size, and condition. One treatment path may simply be controlling symptoms with a catheter. [nafc.org]
However, only a minority of fistulae subsides under this treatment [26]. Thus, surgery remains the treatment of choice [31]. [urotoday.com]
Treatment / Management Treatment of enterovesical fistula includes treatment of the fistula itself and the underlying disease if it is treatable. Therefore, confirming the fistula etiology should be done before planning treatment. [knowledge.statpearls.com]
Despite different techniques have been proposed as yet there is still no standard treatment. [ncbi.nlm.nih.gov]
Prognosis
Treatment and prognosis Surgical resection of the fistula and abnormal segment of bowel is usually required for cure, although in the setting of malignancy this suggests advanced disease (T4) making surgery complex. [radiopaedia.org]
Early detection and treatment may significantly improve the prognosis of patients. [ncbi.nlm.nih.gov]
[…] underwent multistage repair. [69] In general, the overall outcome and prognosis are excellent in patients with non–radiation-induced or cancer-induced fistulae. [emedicine.medscape.com]
Radiation-induced fistulae are more likely to recur, but the long-term patient prognosis may be better if the malignancy for which the radiation was administered has been controlled. [arabmedmag.com]
Etiology
In this review chapter, we cover the etiology, clinical presentation, and various surgical approaches to repairing vesicovaginal and enterovesical fistulas. [ucdavis.pure.elsevier.com]
English : BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology [decs.bvs.br]
Conclusions Entero-vesical fistula is an uncommon complication of both malignant and benign processes and even a rare etiology must be considered, like in our case. [omicsonline.org]
Etiology: Ureterocolic fistula is the most common type of ureteroenteric fistula. Etiologies include colorectal malignancy, post pelvic surgery, radiation therapy and spontaneous fistulas. [ijcasereportsandimages.com]
The primary aim of a diagnostic workup is not to observe the fistular tract itself but to find the etiology of the disease so that an appropriate therapy can be initiated. [ncbi.nlm.nih.gov]
Epidemiology
2006 Allowable Qualifiers English : BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
Epidemiology and pathogenesis of diverticular disease. J Gastrointest Surg. 2008; 12 :1309–1311. [ PubMed ] 5. Song JH, Huh JG, Kim YS, Lee JH, Jang WC, Ok KS, et al. [ncbi.nlm.nih.gov]
Epidemiology Colovesical fistulae are the most common type of fistulous communication between the bowel and the urinary bladder. heT incidence in patients with diverticular disease approximately 2%. [knowledge.statpearls.com]
[…] to the suture line, resulting in the midportion of the graft eroding into adjacent bowel; conversely, primary aortoenteric fistulas almost always result from erosion of the aneurysmal or infected aorta into surrounding areas, most commonly the bowel Epidemiology [emedicine.medscape.com]
Pathophysiology
Pathophysiology An enterovesical fistula usually refers to a predisposing pathophysiologic process. Therefore, the pathophysiology depends on the predisposing cause or disease. [knowledge.statpearls.com]
Inflammatory pathophysiology Diverticulitis accounts for approximately 50-70% of vesicoenteric fistulae. Diverticular fistulae are almost entirely colovesical. [arabmedmag.com]
Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 28. Lentz GM, Krane M. Anal incontinence: diagnosis and management. [nlm.nih.gov]
Such conditions may include: chronic steroid use smoking poorly controlled diabetes mellitus infection malignancy return to top Pathophysiology Fistulas often occur following injury to the vaginal tissue. [sharinginhealth.ca]
Pathophysiology and therapy of chronic radiation-induced injury to the colon. Dig Dis. 1998 Jul-Aug. 16 (4):253-61. [Medline]. Li Y, Ren JA, Wang GF, et al. [emedicine.medscape.com]
Prevention
A high index of suspicion is required to prevent a delay in the diagnosis of this disease condition. As seen in this case report, diagnosis and surgical repair of enterovesical fistula was done three years after myomectomy. [scirp.org]
[…] diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology EH ethnology ET etiology GE genetics HI history IM immunology ME metabolism MI microbiology MO mortality NU nursing PS parasitology PA pathology PP physiopathology PC prevention [decs.bvs.br]
For malformations that involve the mixing of urine and feces, treatment will first focus on diverting the feces away from the urethra to prevent infection and other complications. [cedars-sinai.edu]
To prevent the cross-contamination that occurs with any fistula and to restore normal function to your bladder, the urogynecologists at Women’s Center for Pelvic Wellness repair your fistula surgically by placing healthy tissue over the opening. [search.com]
Turner-Warwick R, Chapple CR (1994) Obstetric and gynaecological injuries of the urinary tract: their prevention and management. In: Bonnar J (Ed) Recent advances in obstetrics and gynaecology. Churchill Livingstone, pp 211–238 Google Scholar 3. [link.springer.com]