Colovesical fistula - diverticular disease
37 year-old male with lower abdominal pain and pain on micturition. No surgical history.
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Multiple sigmoid colonic diverticulae.
Thickened sigmoid colon with pericolic inflammatory change.
Gas tracking across the wall of the sigmoid, with large volume of gas in the bladder ( which is not catheterised ).
This case shows multiple signs to confirm the diagnosis:
1. Thickened adjacent colon with pericolonic inflammatory change
2. Diverticulae in the sigmoid colon
3. Large volume of air in the bladder ( without prior catheterisation or intervention )
4. Gas tracking across the colonic wall into the urinary bladder