Acquired enterovesical fistulas

Abstract

12 patients with acquired enterovesical fistulas
during a period between 1990 and 2002 were reviewed., considering etiological aspects, clinical
presentation, paraclinical examinations and surgical
treatment and comparing them with those in
similar published series.
Etiology includes diverticular disease (six cases),
Crohn’s disease (three cases), radiation injury
(one case) and surgical or instrumental iatrogenia
(two cases).
Specific symptoms and the clinical presentation
were related to the causal disease.
Paraclinical examinations were analysed. The
importance of computerized abdominal tomography
is emphatically stressed.
Finally, treatment and outcomes were considered.
In all cases surgery was performed. The most
common procedure (75%) was intestinal resection
with primary anastomosis (one-stage resection) and
vesical repair. Other procedures were colostomy
without resection (16%) and resection without
anastomosis (8%).
No mortality was registered and the outcome
was favourable in all cases. The functional results
were better in one-stage resection cases.
We concluded that enterovesical fistula is a rare
disease. Etiology and relative frequency is similar
to those in other published series with the only difference
that no neoplastic fistulas were found..
Surgical treatment is effective and one stage resection
and anastomosis is recommended if possible
because the better functional outcome