Khanbhai M, Hodgson C, Mahmood K, Parker M C, Solkar M
Academic Surgery Unit, University Hospital of South Manchester, United Kingdom.
Tameside General Hospital NHS Foundation Trust, United Kingdom.
Int J Surg Case Rep. 2014;5(8):448-50. doi: 10.1016/j.ijscr.2014.03.019. Epub 2014 May 24.
Colo-vesical (CV) fistulae are the most common type of fistulae associated with diverticular disease. Surgery remains the mainstay of treatment, without which, CV fistulae rarely achieve complete healing.
Herein, we report the case of a 62-year-old man who developed a CV fistula after reversal of Hartmann's procedure (initially for management of diverticular abscess), which healed with conservative management alone.
We discuss possibilities of the aetiology of this fistula. The CV fistula may have been initially present, which came to light only after his reversal. Or an iatrogenic fistula that developed at the time of reversal of Hartmann's.
This is the first time that such a fistula has been demonstrated clinically and radiologically to have healed spontaneously without surgery. We recommend that conservative management of CV fistulae should be considered.
结肠膀胱(CV)瘘是与憩室病相关的最常见的瘘管类型。手术仍然是主要的治疗方法,没有手术,CV瘘很少能完全愈合。
在此,我们报告一例62岁男性病例,该患者在Hartmann手术(最初用于治疗憩室脓肿)回纳后发生CV瘘,仅通过保守治疗即愈合。
我们讨论了该瘘管病因的可能性。CV瘘可能最初就存在,只是在回纳后才显现出来。或者是在Hartmann手术回纳时形成的医源性瘘管。
这是首次在临床和放射学上证实这种瘘管未经手术而自发愈合。我们建议应考虑对CV瘘进行保守治疗。