Cases reported "Urinary Bladder Fistula"

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1/9. Youssef's syndrome.

    A case of menouria (Youssef's syndrome) following a vesicovaginal fistula repair is presented. The patient had typical clinical features of cyclic hematuria, absence of vaginal bleeding and complete urinary continence. diagnosis was established by cystoscopy, cystography and hysterosalpingography which disclosed the communication between the bladder and the uterine cavity. Surgical treatment was hysterectomy with the closure of the bladder opening. The authors quote similar cases reported in the literature and attention is also called to the fact that the first case of menouria was reported in the literature by Machado in 1935.
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2/9. Colovesical fistula an unusual complication of cytotoxic therapy in a case of non-Hodgkin's lymphoma.

    A 65-year old man, a known case of non-Hodgkin's lymphoma of base of the tongue and epiglottis presented with complaints of pneumaturia and faecaluria. He had received the first cycle of cytotoxic therapy (CHOP-regimen). At the end of the cycle he developed febrile neutropenia (circulating granulocyte count <1500/mm3). Cystogram showed air in the bladder area and a fistulous communication to a cavity behind the bladder. CT-scan showed air in the bladder, a fistulous communication between the sigmoid colon and bladder along with an intervening small abscess cavity. On exploration a fistulous communication between the sigmoid and bladder along with an intervening small abscess cavity was found. Resection of involved portion of sigmoid and end to end anastomosis along with a diverting colostomy was done. The bladder was closed in two layers with an omental interposition between it and the sigmoid along with a suprapubic cystostomy. The histopathology demonstrated only inflammatory response without any evidence of malignancy or diverticular disease.
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3/9. oligohydramnios and megacolon in a fetus with vesicorectal fistula and anal-urethral atresia: a case report.

    Severe oligohydramnios and extremely dilated bowel filled with hyperechogenic material floating in fluid were the ultrasonographic findings in a fetus at 27 weeks' gestation. Vesicorectal communication and urethral-anal atresia permitted urine to empty into the colon, causing megacolon, oligohydramnios, and markedly increased intraabdominal pressure resulting in pulmonary hypoplasia.
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4/9. "Milky" urine--a child with chyluria.

    A 10-year-old boy with chyluria due to a congenital fistulous communication between the lymphatic system and the bladder is described. Chyluria can be parasitic or non-parasitic. Many causes of non-parasitic chyluria have been reported. lymphography is the preoperative imaging procedure of choice since it demonstrates the site, the calibre and the number of the fistulous communications. lymphoscintigraphy shows very well the site of the fistula but is not as precise as lymphography. However, it has the advantage to be less invasive and is an excellent alternative in the non-surgical cases. The prognosis of non-parasitic chyluria is usually very good and the treatment is mostly conservative.
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5/9. Primary non-Hodgkin's lymphoma of the terminal ileum with enterovesical fistula: a case report.

    A case of primary non-Hodgkin's lymphoma of the terminal ileum with enterovesical fistula is reported. A 50-year-old Malay man presented with haematuria, dysuria and per-rectal bleeding. Intravenous urogram, double contrast enema and an MDP bone scintigram showed a fistulous communication between the bladder and distal ileum. At laparotomy, a large tumour attaching the terminal ileum to the dome of the bladder was found. Histopathological examination of resected small bowel revealed a diffuse histiocytic non-Hodgkin's lymphoma of the small bowel. The bladder mucosa was shown to be normal.
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6/9. Successful fibrin seal closure of a contaminated fistula. Case report.

    In a 43-year-old woman, a large, contaminated fistula, initially with vesicointestinal communication, was successfully closed by application of fibrin seal. The course of three sealing attempts indicated that local pretreatment with antibiotics may have been important for the final result. At 4-year follow-up examination there was no recurrence of the fistula.
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7/9. Non-operative management of a pelvic hydatid cyst communicating with the bladder.

    Two cases are reported of spontaneous rupture of pelvic hydatid cysts into the bladder, which were managed conservatively. The resulting communication between the bladder and the cyst was used advantageously for intravesical instillation of 20% saline to destroy the germinal layer of the hydatid cyst and daughter cysts. Sequential cystographic studies showed disappearance of the extrinsic pressure effect on the bladder as the daughter cysts were evacuated repeatedly per urethram after instillations. Spontaneous sealing off of the communication was documented and confirmed by cytoscopy in 1 case. A plea is made to adopt a non-operative approach in such cases, which permits intravesical and, hence, intracystic scolecidal agent instillation and achieves spontaneous evacuation of daughter cysts. Other factors encouraging conservative management whenever possible are the reportedly high recurrence rate of hydatid cysts postoperatively, the morbidity described with complete excision of pelvic and other hydatid cysts, and the inherent slow process of recurrence (between 5 and 20 years) after complete evacuation of daughter cysts.
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8/9. Crohn's disease with spontaneous cutaneous-urachovesicoenteric fistula.

    This case report presents a rare complication of Crohn's disease in a 28-year-old presenting with an umbilicourachovesicoenteric fistula. Preoperative studies demonstrated communication of the umbilicus, bladder, ileum, and cecum. Preoperative nutritional support and en bloc resection with restoration of continuity primarily was performed with a successful outcome.
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9/9. Hypokalaemic hyperchloraemic metabolic acidosis and vesical stone complicating appendicovesical fistulae.

    Two patients with appendicovesical fistulae are described. Both presented with gastrointestinal and urinary symptoms. Biochemical examination showed hypokalaemic hyperchloraemic metabolic acidosis; radiographic investigations showed a vesical stone and a communication between the bladder and the bowel. The findings at operation suggested that the fistulae may have arisen as complications of previous appendicitis. The diagnosis of appendicovesical fistulae may be difficult but should be considered in the presence of hypokalaemic hyperchloraemic metabolic acidosis and vesical stones.
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