ABSTRACT
Background: Colovesical fistula is a rare complication of inflammatory and neoplasic pelvic diseases [0.2%]
Aim: To report a new case
Case: We report the case of a 74-year-old woman, with a charged previous medical history and had not had hysterectomy. She was admitted because of cystitis with haematuria associated to faecaluria and pneumaturia confirmed by an intravenous pyelogram. Water-soluble contrast medium show the sigmoidovesical fistula. A sigoid sticture is identified at colonoscopy and biopsy was realised. The patient had had sigmoidectomy with Hartmann's procedure. Histologic study confirm the diverticulatis with preidiverticular abcess and fistula
We suggest that early diagnosis and management of sigmoid diverticulatis is required to prevent complicatins like stricture and fistula
Subject(s)
Aged , Female , Humans , Sigmoid Diseases , Diverticulitis, Colonic/complications , Urinary Tract Infections , Urinary Bladder FistulaABSTRACT
In a period of five years we operated 52 patients affected by choledocolithiasis. 38 patients had a laparoscopic approach, 10 patients had directly a laparotomy and 4 patients benefit of a sequential treatment, The conversion rote was 39% because we don't select candidates to laparoscopy, including even patients with acute cholangitis. Main causes of conversion were wedged calculi in the papilla, multiple stones and high inflammation of the common bile duct. Mortality and morbidity were nil. Duration of laparoscopic operation was in a mean of 165 minutes with 8,8 days of hospital stay. Two residual stones were successfully removed by endoscopic sphincterotomy. Lapnroscopic treatment of choledocolithiasis is an effective, safe method; it seems to be the best therapeutic alternative. This technique needs an additional and costly instrumentation and good laparoscopic skills. in order to reduce the conversion rate it is recommended to avoid the laparoscopic approach for patients with acute chotangitis and multiple common bile duct stones