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Colovesical Fistula *
Author(s) -
STEIER MICHAEL E.,
MITTY WILLIAM F.,
NEALON THOMAS F.
Publication year - 1973
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1973.tb01663.x
Subject(s) - medicine , diverticulitis , fistulectomy , colostomy , barium enema , cystoscopy , fistula , surgery , diverticulum (mollusc) , general surgery , cystography , colonoscopy , colorectal cancer , urinary system , cancer
Twenty‐four geriatric patients with colovesical fistula were admitted to St. Vincent's Hospital, New York, between January 1961 and December 1970. A review of these cases showed that only 42 per cent were correctly diagnosed upon admission. Diverticulitis was the leading etiologic factor, and in most cases the fistula was located between the sigmoid and the bladder. The most valuable diagnostic procedures were cystoscopy and barium‐enema x‐ray examination. Pneumaturia (present in 75 per cent of the cases) and fecaluria were significant physical findings, as was abdominal pain. A three‐stage operation — preliminary colostomy, then colonic resection and fistulectomy, and finally closure of the colostomy — is the safest surgical procedure.