Neroladaki Angeliki, Breguet Romain, Botsikas Diomidis, Terraz Sylvain, Becker Christoph D, Montet Xavier
Department of Radiology, Geneva University Hospital, Gabrielle-Perret-Gentil, 4, 1211, Geneva 4, Switzerland.
J Med Case Rep. 2012 Jul 23;6:214. doi: 10.1186/1752-1947-6-214.
Computed tomography colonography, or virtual colonoscopy, is a good alternative to optical colonoscopy. However, suboptimal patient preparation or colon distension may reduce the diagnostic accuracy of this imaging technique.
We report the case of an 83-year-old Caucasian woman who presented with a five-month history of pneumaturia and fecaluria and an acute episode of macrohematuria, leading to a high clinical suspicion of a colovesical fistula. The fistula was confirmed by standard contrast-enhanced computed tomography. Optical colonoscopy was performed to exclude the presence of an underlying colonic neoplasm. Since optical colonoscopy was incomplete, computed tomography colonography was performed, but also failed due to inadequate colon distension. The insufflated air directly accumulated within the bladder via the large fistula.
Clinicians should consider colovesical fistula as a potential reason for computed tomography colonography failure.
计算机断层结肠成像术，即虚拟结肠镜检查，是光学结肠镜检查的一种良好替代方法。然而，患者准备不充分或结肠扩张不足可能会降低这种成像技术的诊断准确性。
我们报告了一名83岁白种女性的病例，该患者有5个月的气尿和粪尿病史以及一次肉眼血尿急性发作，高度怀疑存在结肠膀胱瘘。通过标准的对比增强计算机断层扫描证实了瘘管的存在。进行了光学结肠镜检查以排除潜在的结肠肿瘤。由于光学结肠镜检查不完整，进行了计算机断层结肠成像术，但由于结肠扩张不足也未成功。注入的空气通过大瘘管直接积聚在膀胱内。
临床医生应将结肠膀胱瘘视为计算机断层结肠成像术失败的潜在原因。
