eMedicine Specialties > Urology > Fistulas

Enterovesical Fistula: Multimedia

Author: Joseph Basler, MD, PhD, Professor, Department of Urology, University of Texas Health Science Center at San Antonio; Chief, Section of Urology, Audie Murphy Veterans Affairs Hospital
Coauthor(s): Christopher H Cantrill, MD, Resident Physician, Department of Urology, University of Texas Health Science Center, San Antonio; Angela Kamerer Schang, MD, Attending Urologist, McKay Urology; Ann S Fenton, MD, MPH, Chief, Urology Flight Surgical Services/SGOSU, 1st Fighter Wing Hospital, Langley Air Force Base; Consulting Staff, Department of Urology, Naval Medical Center Portsmouth; Assistant Professor, Eastern Virginia Medical School
Contributor Information and Disclosures

Updated: Nov 18, 2009

Multimedia

CT scan showing the adherence of the sigmoid colo...
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Media file 1: CT scan showing the adherence of the sigmoid colon to the lateral edge of the bladder.
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CT scan showing the adherence of the sigmoid colo...

CT scan showing the adherence of the sigmoid colon to the lateral edge of the bladder.

A lower cut of the CT scan from Image 1. Note the...
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Media file 2: A lower cut of the CT scan from Image 1. Note the sigmoid colon in direct proximity to the fistula and the air in the bladder.
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A lower cut of the CT scan from Image 1. Note the...

A lower cut of the CT scan from Image 1. Note the sigmoid colon in direct proximity to the fistula and the air in the bladder.

A CT scan one cut further inferiorly from Images ...
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Media file 3: A CT scan one cut further inferiorly from Images 1-2 showing the typical air pattern in the bladder and more obvious inflammatory changes at the site of the vesicoenteric fistula.
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A CT scan one cut further inferiorly from Images ...

A CT scan one cut further inferiorly from Images 1-2 showing the typical air pattern in the bladder and more obvious inflammatory changes at the site of the vesicoenteric fistula.

An endoscopic view of the colovesical fistula (up...
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Media file 4: An endoscopic view of the colovesical fistula (upper right) presented in Images 1-3. Note the prominent edema and erythema characteristic of the fistula (ie, herald patch). Occasionally, a whitish discharge with the consistency of toothpaste can be observed emanating from the orifice. The presentation of a vesicoenteric fistula includes the presence of air, fecal material, and polymicrobial recurrent urinary tract infection.
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An endoscopic view of the colovesical fistula (up...

An endoscopic view of the colovesical fistula (upper right) presented in Images 1-3. Note the prominent edema and erythema characteristic of the fistula (ie, herald patch). Occasionally, a whitish discharge with the consistency of toothpaste can be observed emanating from the orifice. The presentation of a vesicoenteric fistula includes the presence of air, fecal material, and polymicrobial recurrent urinary tract infection.

A white mucinous exudate is observed emanating fr...
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Media file 5: A white mucinous exudate is observed emanating from the site of a colovesical fistula in a patient with both a sigmoid diverticular abscess and colon cancer.
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A white mucinous exudate is observed emanating fr...

A white mucinous exudate is observed emanating from the site of a colovesical fistula in a patient with both a sigmoid diverticular abscess and colon cancer.

After a bladder wash-out, the fistula (see Image ...
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Media file 6: After a bladder wash-out, the fistula (see Image 5) appears as a raised, edematous, sessile lesion in the bladder. The air bubble is observed at the top of the photo, and some remnant mucus threads are adherent at the bottom.
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After a bladder wash-out, the fistula (see Image ...

After a bladder wash-out, the fistula (see Image 5) appears as a raised, edematous, sessile lesion in the bladder. The air bubble is observed at the top of the photo, and some remnant mucus threads are adherent at the bottom.

The edema surrounding the fistula often extends f...
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Media file 7: The edema surrounding the fistula often extends for a considerable distance around the bladder wall. A cobblestone appearance is typical when chronic inflammation is present.
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The edema surrounding the fistula often extends f...

The edema surrounding the fistula often extends for a considerable distance around the bladder wall. A cobblestone appearance is typical when chronic inflammation is present.

Colovesical fistula identified on CT scan in a pa...
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Media file 8: Colovesical fistula identified on CT scan in a patient with diverticular disease and fecaluria. Arrow – fistula, B – bladder, C – sigmoid colon with diverticula.
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Colovesical fistula identified on CT scan in a pa...

Colovesical fistula identified on CT scan in a patient with diverticular disease and fecaluria. Arrow – fistula, B – bladder, C – sigmoid colon with diverticula.

Same patient as Image 8 with colovesical fistula ...
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Media file 9: Same patient as Image 8 with colovesical fistula visualization on sagittal MRI. Arrow – fistula, B – bladder, C – sigmoid colon.
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Same patient as Image 8 with colovesical fistula ...

Same patient as Image 8 with colovesical fistula visualization on sagittal MRI. Arrow – fistula, B – bladder, C – sigmoid colon.

Same patient as Images 8 and 9. Operative view fr...
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Media file 10: Same patient as Images 8 and 9. Operative view from superior and anterior showing the bladder (B) and colon (C) with area of erythema at the site surrounding the fistula.
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Same patient as Images 8 and 9. Operative view fr...

Same patient as Images 8 and 9. Operative view from superior and anterior showing the bladder (B) and colon (C) with area of erythema at the site surrounding the fistula.

Cystoscopic view of an anastomotic urethrorectal ...
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Media file 11: Cystoscopic view of an anastomotic urethrorectal fistula that developed after radical prostatectomy. The patient remains asymptomatic with occasional pneumaturia. This is an uncommon complication of radical prostatectomy.
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Cystoscopic view of an anastomotic urethrorectal ...

Cystoscopic view of an anastomotic urethrorectal fistula that developed after radical prostatectomy. The patient remains asymptomatic with occasional pneumaturia. This is an uncommon complication of radical prostatectomy.

More on Enterovesical Fistula

Overview: Enterovesical Fistula
Workup: Enterovesical Fistula
Treatment: Enterovesical Fistula
Follow-up: Enterovesical Fistula
Multimedia: Enterovesical Fistula
References
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Further Reading

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Keywords

enterovesical fistula, enterovesical fistulae, colovesical fistula, colovesical fistulae, intestinovesical fistula, vesicocolic fistula, rectovesical fistula, ileovesical fistula, appendicovesical fistula, pneumaturia, fecaluria, urinary tract infections, UTIs, bowel disease, vesicoenteric fistula, rectourethral fistula, diverticular disease, Crohn disease, appendicitis, imperforate anus, diverticulitis, Crohn colitis, Meckel diverticulum, genitourinary coccidioidomycosis, pelvic actinomycosis, colorectal cancer, prostatectomy, laparoscopic inguinal hernia repair, Gouverneur syndrome, sigmoid diverticular disease

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Contributor Information and Disclosures

Author

Joseph Basler, MD, PhD, Professor, Department of Urology, University of Texas Health Science Center at San Antonio; Chief, Section of Urology, Audie Murphy Veterans Affairs Hospital
Joseph Basler, MD, PhD is a member of the following medical societies: American Urological Association, Society for Basic Urologic Research, Society of University Urologists, Society of Urologic Oncology, Southwest Oncology Group, and Texas Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Christopher H Cantrill, MD, Resident Physician, Department of Urology, University of Texas Health Science Center, San Antonio
Christopher H Cantrill, MD is a member of the following medical societies: American Association of Clinical Urologists, American Urological Association, and Endourological Society
Disclosure: Nothing to disclose.

Angela Kamerer Schang, MD, Attending Urologist, McKay Urology
Angela Kamerer Schang, MD is a member of the following medical societies: American Medical Association and American Urological Association
Disclosure: Nothing to disclose.

Ann S Fenton, MD, MPH, Chief, Urology Flight Surgical Services/SGOSU, 1st Fighter Wing Hospital, Langley Air Force Base; Consulting Staff, Department of Urology, Naval Medical Center Portsmouth; Assistant Professor, Eastern Virginia Medical School
Ann S Fenton, MD, MPH is a member of the following medical societies: American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Erik T Goluboff, MD, Professor, Department of Urology, College of Physicians and Surgeons, Columbia University; Director of Urology, Allen Pavilion, New York Presbyterian Hospital
Erik T Goluboff, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Urological Association, Medical Society of the State of New York, New York Academy of Medicine, Phi Beta Kappa, and Society for Basic Urologic Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Gyrus-ACMI Honoraria Speaking and teaching

Chief Editor

Bradley Fields Schwartz, DO, FACS, Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine
Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

 
 
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