A vesicointestinal fistula (or intestinovesical fistula) is a form of

fistula A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

between the

bladder The urinary bladder, or simply bladder, is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans the bladder is a distensible organ that sits on the pelvic floor. Urine enters ...

and the

bowel The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and ...

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" * Bladder and colon: "vesicocolic" or "colovesical" * Bladder and rectum: "vesicorectal" or "rectovesical"

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 A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis) and when it affects the upper urinary tract it is known as a kidne ...

. Migration of urine through the fistula into the bowel may cause rectal passage of urine.

Causes

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

Diagnosis

Various modalities of diagnosis are available: *

Cystoscopy Cystoscopy is endoscopy of the urinary bladder via the urethra. It is carried out with a cystoscope. The urethra is the tube that carries urine from the bladder to the outside of the body. The cystoscope has lenses like a telescope or microscop ...

* Colonoscopy * Poppy seed test * Transabdominal ultrasonography * Abdominopelvic CT * MRI *

Barium enema A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs (X-ray pictures) are taken while barium sulfate, a radiocontrast agent, fills the colon via an ...

* Bourne test * Cystogram A definite algorithm of tests is followed for making the diagnosis.

References

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