Colovesicular Fistula

Abstract

A fistula is an atypical connection between two epithelial surfaces, in the case of an enterovesical fistula between the urinary and gastrointestinal systems. These may be the result of a number of causes including: 1. Congenital abnormalities 2. Inflammatory diseases of the bowel (such as diverticulitis and Crohn鈥檚 Disease) 3. Cancer 4. Infection 5. Trauma 6. Iatrogenic (such as a post-operative complication) [3] A colovesical fistula (colovesicular fistula), an abnormal connection between the bladder and colon, is a known complication of diverticular disease, occurring in around 2%-22% of patients suffering from diverticulosis. These fistulae tend to occur three times more often in males than in females. The difference in occurrence is thought to be related to the fact that in females there is the uterus which may prevent the colon and bladder from coming into contact with each other. In fact in females other types of fistulae, such as vesicovaginal and enterovaginal, occur more frequently than colovesical fistulae. [2] Aim: This article highlights the importance of the early identification and management of colovesical fistulae, which although uncommon complications of diverticulitis, can be very uncomfortable for the patient and if not treated early, can lead to high morbidity.