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Diverticulitis With Colovesical Fistula

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0:00

Okay, so diverticulitis complicated

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by colo-vesicular fistula.

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These patients will present

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with pneumaturia or fecaluria.

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Um, the incidence is low, thank goodness, at about 2%.

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Colo-vesicular fistulas are also more common

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in men, whereas for women it's more common

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to have colouterine or vaginal fistulas.

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Uh, lucky us.

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These are pretty much a disaster.

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You will have urinary tract infections.

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They're very hard to treat.

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Um, sometimes they have to be

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treated surgically for sure.

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I've had cases where they're very, very

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subtle, and I've called doctors to say, oh,

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you just have dots of air in the bladder.

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Um, I see a small little fistula, and

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they'll say, oh, this gentleman's had,

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you know, years and years of unknown.

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Urinary tract infection.

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So it is a cause for urinary tract

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infections that can be pretty subtle.

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So look for your colo fistulas.

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Anytime you see a dot of air in the bladder, definitely

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to make sure there's no fistula to the colon.

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Faculty

Laura L Avery, MD

Assistant Professor of Emergency Radiology Harvard Medical School

Massachusetts General Hosptial

Tags

Large Bowel-Colon

Infectious

Gastrointestinal (GI)

Emergency

CT

Body