RESUMO
Colovesical fistula is an infrequent complication of diverticular disease that presents with pneumaturia, fecaluria, dysuria and, rarely, hematuria or hematochezia. Here we present a case of concurrent hematuria and rectal bleeding arising from a diverticular bleed traversing a previously undiagnosed colovesical fistula. Other causes of colovesical fistula include Crohn's disease, radiation, and malignancy, though it is most commonly caused by complicated diverticulitis as in this case. Computed tomography (CT) imaging, cystoscopy, and gastrograffin enema have been described as high-yield diagnostic tests. Interestingly, colonoscopy is only successful in diagnosing colovesical fistula in approximately 55% of cases. Management often requires surgical intervention, as in this case, given limited success with conservative management. Colovesical fistula should be considered in patients presenting with fecaluria, pneumaturia, and dysuria as well as in cases of hematuria.
Assuntos
Colite Colagenosa/diagnóstico , Colonoscopia , Enterocolite Pseudomembranosa/diagnóstico , Budesonida/uso terapêutico , Colite Colagenosa/tratamento farmacológico , Colite Colagenosa/patologia , Colite Microscópica/diagnóstico , Colite Microscópica/tratamento farmacológico , Colite Microscópica/patologia , Enterocolite Pseudomembranosa/tratamento farmacológico , Enterocolite Pseudomembranosa/patologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Pessoa de Meia-IdadeRESUMO
An unusual case of campylobacter pouchitis resembling the endoscopic appearance of Crohn's disease is reported.