Colovesical fistula in a patient with diverticular disease and foreign body of the colonj

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Abstract

A clinical observation of a 50-year-old patient with colonic diverticular disease with perforation of one diverticulum by a fish bone and the formation of a colovesical fistula is presented in the article. The history of the disease, clinical picture, the course of the disease, results of pre-hospital and hospital examination, methods of treatment of the patient were analyzed. The presented material is illustrated by MSCT images, photographs made during the surgical treatment, results of histological examination. Surgical treatment included lower midline laparotomy, resection of the sigmoid colon and bladder with complete removal of the fistula with a diverticulum and bone inside it as a single block, formation of a colostomy, suturing the bladder defect tightly with urethral drainage with a Foley catheter. There were no complications during the operation and in the early postoperative period, the patient was discharged at the usual time. At a later date, a reconstructive operation was performed with the restoration of the passage of intestinal contents, without complications. A review of the literature on the diagnosis and treatment of patients with colovesical fistulas is presented.

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About the authors

Ruslan N. Simanov

Petrozavodsk State University; V.A. Baranov Republican Hospital

Author for correspondence.
Email: Ruslansimanov@yandex.ru
ORCID iD: 0000-0003-1246-7233
SPIN-code: 3747-8245

Postgraduate Student, Department of the Hospital Therapy of the Medical Institute; Urologist, Urology Department

Russian Federation, Petrozavodsk, Republic of Karelia; Petrozavodsk, Republic of Karelia

Alexey I. Fetyukov

Petrozavodsk State University; V.A. Baranov Republican Hospital

Email: fetukov@petrsu.ru
ORCID iD: 0000-0001-7228-3618
SPIN-code: 8391-1188

Dr. Sci. (Med.), Head of the Department of Hospital Surgery, Ear, Nose, Throat diseases, Ophthalmology, Dentistry, Oncology, Urology of the Medical Institute; Surgeon, Surgery Department

Russian Federation, Petrozavodsk, Republic of Karelia; Petrozavodsk, Republic of Karelia

Viktor A. Malyshev

Republican Perinatal Center

Email: urologmalishev@mail.ru
ORCID iD: 0000-0002-6375-2686
SPIN-code: 6699-1673

Cand. Sci. (Med.), Urologist of the Consultative and Diagnostic Department with the male reproductive health care office

Russian Federation, Petrozavodsk, Republic of Karelia

Pavel N. Kagachev

V.A. Baranov Republican Hospital

Email: p.kagachev@mail.ru
ORCID iD: 0000-0001-7213-417X
SPIN-code: 6785-7085

Surgeon, Surgery Department

Russian Federation, Petrozavodsk, Republic of Karelia

Olga Yu. Barysheva

Petrozavodsk State University; V.A. Baranov Republican Hospital

Email: hosptherapy@mail.ru
ORCID iD: 0000-0002-2133-4849
SPIN-code: 4896-5434

Dr. Sci. (Med.), Professor of the Department of Hospital Therapy of the Medical Institute; Head of the Nephrology Department

Russian Federation, Petrozavodsk, Republic of Karelia; Petrozavodsk, Republic of Karelia

References

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Supplementary files

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2. Fig. 1. Multispiral computed tomography of the pelvic organs in native mode. Axial projection. The arrow indicates the air in the projection of the bottom and anterior wall of the bladder

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3. Fig. 2. Multispiral computed tomography of the pelvic organs. Axial projection: а — native mode; b — contrast enhancement. Arrows indicate the location of the fistula with bone and multiple diverticulas

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4. Fig. 3. Contrast-enhanced multispiral computed tomography. Three-dimensional reconstruction: a — lateral view; b — top view. The arrow sindicate the fistula with bone in the area of the bottom of the bladder

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5. Fig. 4. Fistulous opening in the sigmoid diverticulum. Top view. The arrow indicates the probe in the fistulous opening

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6. Fig. 5. Fistulous opening in the bladder wall. Area of the bottom of the bladder. The arrow indicates the fistulous opening: a — top view; b — side view

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7. Fig. 6. Material sent for histological examination. Fishbone extracted from a fistulous hole

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