Colovesical fistula - diverticular disease

Case contributed by Dr Ian Bickle

Presentation

37 year-old male with lower abdominal pain and pain on micturition. No surgical history.

Patient Data

Age: 37
Gender: Male

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 ).

Case Discussion

One of the commoner causes of a colovesical fistula is complicated diverticular disease.

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

 

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Case information

rID: 39528
Case created: 8th Sep 2015
Last edited: 26th May 2016
Inclusion in quiz mode: Included

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