1/256. Enterovesical fistula complicating pregnancy. A case report. BACKGROUND: Enterovesical fistula is a rare cause of recurrent urinary tract infections. This condition is unusual in young people as common etiologies include diverticular disease and cancer. When an enterovesical fistula occurs in women of childbearing age, Crohn's disease is a likely cause. To our knowledge, enterovesical fistula complicating pregnancy has not been reported before. CASE: A pregnant woman with recurrent urinary tract infections was evaluated. cystoscopy was suggestive of an enterovesical fistula, which was confirmed by charcoaluria following oral charcoal administration. The prenatal course was complicated by two episodes of hemorrhagic cystitis despite antibiotic prophylaxis. The patient had an uncomplicated term spontaneous vaginal delivery. An upper gastrointestinal series performed postpartum was suggestive of Crohn's disease and confirmed an enterovesical fistula. Surgical repair was successfully performed three months following delivery, revealing Crohn's disease. CONCLUSION: Enterovesical fistula may be an unusual cause of recurrent urinary tract infections in pregnancy. In this case, enterovesical fistula was the presenting symptom of Crohn's disease. ( info) |
| iliac artery aneurysm rupture can be rapidly fatal if not diagnosed immediately. These aneurysms usually present in patients with other aneurysmal diseases of the aortoiliac arterial system. If not diagnosed and surgically repaired, iliac artery aneurysms can proceed to expand and ultimately rupture, usually presenting with back, flank, or abdominal pain and, possibly, signs of systemic shock. We present an unusual case report of a common iliac artery aneurysm rupture presenting as gross hematuria due to an arteriovesical fistula. Only three other cases of arteriovesical fistulae have been reported previously. Unlike the case presented, all three of these cases involved trauma or surgical instrumentation or manipulation of the bladder. ( info) |
3/256. Rectovesical fistula treated by covered self-expanding prosthesis: report of a case. Postoperative rectovesical fistulas require surgical intervention for their treatment. We present a case treated by placement of a silicone self-expanding prosthesis in the rectum and vesical drainage and give technical details of the procedure. ( info) |
4/256. Gangrenous cystitis: a rare cause of colovesical fistula. A case of gangrenous cystitis presenting as a colovesical fistula in an elderly woman is described. The literature on this rare condition is reviewed. ( info) |
5/256. Vesicouterine fistula after manual removal of placenta in a woman with previous cesarean section. Vesicouterine fistula is one of the less common acquired urogenital fistula and a rare event in obstetrics. We report a case which occurred after a vaginal delivery followed by manual removal of placenta in a woman who had a previous cesarean section. The fistula was successfully repaired 5 weeks after delivery. ( info) |
6/256. Laparoscopic treatment of vesicouterine fistula. Vesicouterine fistula are rare disorders that are most commonly repaired by laparotomy. A specific type of vesicouterine fistula, vesicocervical fistula, was repaired successfully by laparoscopy. This procedure was associated with minimal blood loss and morbidity, and the patient's hospital stay was less than 24 hours. (J Am Assoc Gynecol Laparosc 6(3):339-341, 1999) ( info) |
7/256. Inferior vesical fistula. Exstrophy variants are uncommon developmental anomalies of the bladder; the variants involving only the bladder neck are extremely rare. There are only two case reports of inferior vesical fissure to date, and inferior vesical fistula (IVF) as an exstrophy variant has not been described previously. We report a case of IVF in a 20-month-old female. The urethra was normal in calibre and position and the bladder capacity was adequate. Simple closure of the fistula was followed by a normal micturition pattern. ( info) |
8/256. Vesicocutaneous fistula 23 years after hip arthroplasty. A case report. Vesicocutaneous fistula after total hip replacement is a very rare but severe complication, which can appear months or years after operation. Intrapelvic cement (methylmethacrilate) spilling, loosening and dislocation of the prosthesis and infection are believed to be the cause of fistula formation. Only 4 cases of this kind of fistula have been reported in the literature. A new case of vesicocutaneous fistula is presented. The fistula developed 23 years after arthroplasty mainly because of hip-joint infection. Urinary tract symptoms caused by urinary infection appeared only few months earlier. ( info) |
9/256. Spontaneous closure of vesicouterine fistula. Account for effective hormonal treatment. OBJECTIVES: To analyze the incidence of spontaneous closure, or non-surgical resolution, of vesicouterine fistula and discuss the resultant implications for the management. methods: review of the literature supplemented by case report of a young woman with spontaneous healing of vesicouterine fistula. RESULTS: This is the 41st patient with spontaneous closure of vesicouterine fistula reported to date. Her clinical course was suggestive of endocrine involvement in the lesion's formation. Spontaneous healing was observed in 5% of 796 vesicouterine fistula cases. Induction of amenorrhea was effective in 8 (89%) of the 9 patients treated, a rate significantly higher (p < 0.001) than that observed without hormonal manipulation (4%). CONCLUSIONS: Conservative management by means of hormonal treatment should be considered before surgical repair. We suggest the role of estrogens and the endometrium in the formation of vesicouterine fistulas. ( info) |
10/256. Antenatal diagnosis of vesicouterine fistula. BACKGROUND: In pregnancy, vesicouterine fistulas usually are diagnosed postpartum after cesarean deliveries. CASE: An 18-year-old woman, gravida 3, para 2, with two prior cesarean deliveries had pain and apparent rupture of membranes at 23 weeks' gestation. At 26 weeks' gestation, she developed increasing suprapubic pain and irregular contractions. Ultrasonographic findings included a small uterine defect and possible ballooning of membranes into her bladder. Cytoscopy showed ballooning of amnion into the bladder dome. A viable 900-g female infant was delivered by classic cesarean, the fistulous tract was excised, and the rupture sites were repaired. CONCLUSION: Vesicouterine fistulas might be diagnosed antenatally. With continued contractions and associated uterine rupture, cesarean delivery can be done with excision of the fistulous tract and repair of the rupture sites. ( info) |