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. 2014;5(8):448-50.
doi: 10.1016/j.ijscr.2014.03.019. Epub 2014 May 24.

Colo-vesical fistula: Complete healing without surgical intervention

M Khanbhai  1 , C Hodgson  2 , K Mahmood  2 , M C Parker  3 , M Solkar  4
Affiliations

Colo-vesical fistula: Complete healing without surgical intervention

M Khanbhai et al. Int J Surg Case Rep. 2014.

Abstract

Introduction: Colo-vesical (CV) fistulae are the most common type of fistulae associated with diverticular disease. Surgery remains the mainstay of treatment, without which, CV fistulae rarely achieve complete healing.

Presentation of case: Herein, we report the case of a 62-year-old man who developed a CV fistula after reversal of Hartmann's procedure (initially for management of diverticular abscess), which healed with conservative management alone.

Discussion: We discuss possibilities of the aetiology of this fistula. The CV fistula may have been initially present, which came to light only after his reversal. Or an iatrogenic fistula that developed at the time of reversal of Hartmann's.

Conclusion: This is the first time that such a fistula has been demonstrated clinically and radiologically to have healed spontaneously without surgery. We recommend that conservative management of CV fistulae should be considered.

Keywords: Colo-vesical fistula; Diverticular complications; Non-operative management.

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Figures

Fig. 1
Fig. 1
Colon is abutting the urinary bladder with evidence of a tiny air-pocket (red arrow) in the bladder. Colo-vesical fistula suspected, although no direct communication seen. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of the article.)
Fig. 2
Fig. 2
There is clear fistulation between the sigmoid colon and urinary bladder (red arrow). Air seen in the urinary bladder. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of the article.)
Fig. 3
Fig. 3
No fistula visualised due to intact fat plane (red arrow) between sigmoid colon and urinary bladder. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of the article.)
See this image and copyright information in PMC

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