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Vesico-colic fistulae in the Grampian region: presentation, assessment, management and outcome.
J R Coll Surg Edinb. 1997 Jun; 42(3):182-5.JR

Abstract

Over a 12-year period, 67 patients presented with a vesico-colic fistula. The mean age was 69 years (range 19-96 years), with symptoms predominantly referred to the urinary tract. Cystoscopy and barium enema confirmed the presence of a fistula in 60 and 44% of patients respectively. A computerized tomography (CT) scan, used in only seven patients, revealed the fistula in each case. The underlying pathology included diverticular disease (62%), carcinoma (27%) and inflammatory bowel disease (6%). Fifty-one patients proceeded to surgery, of whom 32 (63%) had a sigmoid/recto sigmoid resection with primary anastomosis, and 13 (25%) a Hartmann's procedure. A diverting colostomy alone was employed to palliate cases of widespread carcinoma. No patient subsequently had the Hartmann's reversed. In addition to colonic resection, 48 (92%) patients had a simultaneous bladder procedure, varying from simple oversew in 32 (70%) patients to cystectomy and ileal conduit in three (6%). Wedge excision with primary bladder closure was practised in 12 (24%). Fistula recurrence occurred in seven (14%) patients, and the 30-day mortality was 10%. Surgery for vesico-colic fistula has an appreciable morbidity and mortality, yet if offers the only hope of achieving permanent symptomatic control.

Authors+Show Affiliations

Driver CP
Aberdeen Royal Hospitals NHS Trust, Foresterhill, UK.
Anderson DN
No affiliation info available
Findlay K
No affiliation info available
Keenan RA
No affiliation info available
Davidson AI
No affiliation info available

MeSH

AdultAge FactorsAgedAged, 80 and overAnastomosis, SurgicalBarium SulfateCarcinomaColectomyColon, SigmoidColonic DiseasesColonic NeoplasmsColostomyContrast MediaCystectomyCystoscopyDiverticulum, ColonEnemaFemaleHumansInflammatory Bowel DiseasesIntestinal FistulaMaleMiddle AgedPalliative CareRectumRecurrenceScotlandSurvival RateTomography, X-Ray ComputedTreatment OutcomeUrinary Bladder FistulaUrinary Diversion

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9195812

Citation

Driver, C P., et al. "Vesico-colic Fistulae in the Grampian Region: Presentation, Assessment, Management and Outcome." Journal of the Royal College of Surgeons of Edinburgh, vol. 42, no. 3, 1997, pp. 182-5.
Driver CP, Anderson DN, Findlay K, et al. Vesico-colic fistulae in the Grampian region: presentation, assessment, management and outcome. J R Coll Surg Edinb. 1997;42(3):182-5.
Driver, C. P., Anderson, D. N., Findlay, K., Keenan, R. A., & Davidson, A. I. (1997). Vesico-colic fistulae in the Grampian region: presentation, assessment, management and outcome. Journal of the Royal College of Surgeons of Edinburgh, 42(3), 182-5.
Driver CP, et al. Vesico-colic Fistulae in the Grampian Region: Presentation, Assessment, Management and Outcome. J R Coll Surg Edinb. 1997;42(3):182-5. PubMed PMID: 9195812.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vesico-colic fistulae in the Grampian region: presentation, assessment, management and outcome. AU - Driver,C P, AU - Anderson,D N, AU - Findlay,K, AU - Keenan,R A, AU - Davidson,A I, PY - 1997/6/1/pubmed PY - 1997/6/1/medline PY - 1997/6/1/entrez SP - 182 EP - 5 JF - Journal of the Royal College of Surgeons of Edinburgh JO - J R Coll Surg Edinb VL - 42 IS - 3 N2 - Over a 12-year period, 67 patients presented with a vesico-colic fistula. The mean age was 69 years (range 19-96 years), with symptoms predominantly referred to the urinary tract. Cystoscopy and barium enema confirmed the presence of a fistula in 60 and 44% of patients respectively. A computerized tomography (CT) scan, used in only seven patients, revealed the fistula in each case. The underlying pathology included diverticular disease (62%), carcinoma (27%) and inflammatory bowel disease (6%). Fifty-one patients proceeded to surgery, of whom 32 (63%) had a sigmoid/recto sigmoid resection with primary anastomosis, and 13 (25%) a Hartmann's procedure. A diverting colostomy alone was employed to palliate cases of widespread carcinoma. No patient subsequently had the Hartmann's reversed. In addition to colonic resection, 48 (92%) patients had a simultaneous bladder procedure, varying from simple oversew in 32 (70%) patients to cystectomy and ileal conduit in three (6%). Wedge excision with primary bladder closure was practised in 12 (24%). Fistula recurrence occurred in seven (14%) patients, and the 30-day mortality was 10%. Surgery for vesico-colic fistula has an appreciable morbidity and mortality, yet if offers the only hope of achieving permanent symptomatic control. SN - 0035-8835 UR - https://www.unboundmedicine.com/medline/citation/9195812/Vesico_colic_fistulae_in_the_Grampian_region:_presentation_assessment_management_and_outcome_ L2 - https://medlineplus.gov/colonicdiseases.html DB - PRIME DP - Unbound Medicine ER -