A Case of Vesicosigmoidal Fistula Due to Colon Diverticulitis

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  • Ｓ状結腸憩室炎による結腸膀胱瘻の１例

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A 46–year–old man admitted for miction pain and pneumaturia was found in cystoscopy to have mucosal edema with left posterior bladder wall ulceration. Abdominal computed tomography (CT) showed multiple sigmoid diverticulosis with inflamed paracolic tissue, urinary bladder wall thickening, and air density 1.7 cm in diameter between the sigmoid colon and bladder. Based on a diagnosis of vesicosigmoidal fistula, he was treated conservatively, but relapsed and pneumaturia and enteruria occurred 4 months later. No complications or recurrence was seen following fistulectomy. Sigmoidectomy with cystectomy has been reported necessary for vesicosigmoidal fistula. Our subject was diagnosed with multiple sigmoid and descending colon diverticula. We considered sigmoid and descending colon resection for all diverticula to be high invasive and his prostatitis history indicated cystectomy reducing bladder volume could aggravate thamuria, so we conducted only fistulectomy.

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