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ID 37745
本文ファイル
著者
Miyaso, Hideaki
Iwakawa, Kazuhide
Hamada, Yuki
Yasui, Nanako
Nishii, Gou
Akai, Masaaki
Kawada, Kengo
Nonoshita, Takashi
Kajioka, Hiroki
Isoda, Kenta
Kitada, Kouji
Nishie, Manabu
Hamano, Ryosuke
Tokunaga, Naoyuki
Tsunemitsu, Yosuke
Otsuka, Shinya
Inagaki, Masaru
Iwagaki, Hiromi
キーワード
Colovesical fistula
Diverticulitis
NDC
医学
抄録(英)
Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%). The abilities of various preoperative investigations to identify CVF were: computed tomography (CT), 88.9%; magnetic resonance imaging, 40%; cystoscopy, 30%, and gastrografin irrigoscopy, 22.2%. Colonoscopy (0%) was not diagnostic. Bowel resection was performed in nine of ten patients. When inflammation was intense, covering ileostomy was performed, and an omental plasty was placed between the bowel anastomosis and bladder. When CVF is suspected, we recommend CT followed by colonoscopy and cystoscopy as a first-line investigation to rule out malignancy as a cause. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. Primary colic anastomosis appears to be safely performed by applying omental plasty and covering ileostomy.
掲載誌名
Hiroshima Journal of Medical Sciences
64巻
1-2号
開始ページ
9
終了ページ
13
出版年月日
2015-06
出版者
Hiroshima University Medical Press
ISSN
0018-2052
NCID
言語
英語
NII資源タイプ
紀要論文
広大資料タイプ
学内刊行物(紀要等)
DCMIタイプ
text
フォーマット
application/pdf
著者版フラグ
publisher
権利情報
Hiroshima University Medical Press
部局名
医歯薬保健学研究科
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