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SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences
Enterovesical fistula
Other Resources UpToDate PubMed

Enterovesical fistula

Contributors: Casey Silver MD, Christine Osborne MD, Michael W. Winter MD
Other Resources UpToDate PubMed

Synopsis

An enterovesical fistula is an abnormal connection between the bowel and bladder, with the most common form being a colovesical fistula that forms between the sigmoid colon and the dome of the bladder. Fistulae are more common in males than females, with a 3:1 male-to-female ratio.

Diverticular disease is the most common underlying disease leading to fistula formation. Other common causes include incomplete separation of the urinary and digestive systems during development, infection in the setting of diverticulitis, inflammatory conditions such as Crohn disease, cancer, trauma, or previous surgical procedures.

Patients with enterovesical fistulae typically present with suprapubic pain, dysuria, frequency, and symptoms of urinary tract infection. Gouverneur syndrome, or suprapubic pain, frequency, dysuria, and tenesmus, are the hallmarks of enterovesical fistulae. Many patients also present with recurrent urinary tract infections not eradicated with multiple courses of antibiotics.

Pneumaturia, or air in the urinary stream, occurs in 50%-60% of patients with enterovesical fistulae and is more common in patients with diverticular disease and Crohn disease than in those with cancer. Fecaluria, or stool in the urine, is pathognomonic and occurs in 40% of patients with fistula, most commonly those with Crohn disease.

Codes

ICD10CM:
N32.1 – Vesicointestinal fistula

SNOMEDCT:
40046003 – Intestinovesical fistula

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:04/17/2019
Last Updated:05/05/2019
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Enterovesical fistula
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A medical illustration showing key findings of Enterovesical fistula : Abdominal pain, Fever, Recurring episodes or relapses, Urinary frequency, Dysuria, Pneumaturia, GI hemorrhage
Copyright © 2024 VisualDx®. All rights reserved.