Raymond P L, Gibler W B
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232.
Am J Emerg Med. 1989 Mar;7(2):191-5. doi: 10.1016/0735-6757(89)90137-x.
A case of colovesical fistula is described, revealing the pathognomonic findings of terminal pneumaturia and fecaluria. The sensitivity and specificity of various procedures that can be performed in the emergency department for confirmation of the diagnosis are evaluated. Dye studies including methylene blue, the Bourne test, the modified diatrizoate (gastrograffin) test, barium enema and cystography, cystoscopy and colocystoscopic examination, and computed tomography and nuclear medicine scans are discussed as diagnostic modalities. Surgical treatment of colovesical fistula is briefly reviewed. As colovesical fistula are thought to occur in 2% to 22% of patients with known diverticular disease, it is reasonable to question all patients with recurrent urinary tract infection, especially those with known disease of the colon, regarding symptoms of terminal pneumaturia and fecaluria.
本文描述了一例结肠膀胱瘘病例，揭示了终末气尿和粪尿这一具有诊断特征性的表现。对可在急诊科进行的用于确诊的各种检查方法的敏感性和特异性进行了评估。讨论了包括亚甲蓝染色检查、伯恩试验、改良泛影葡胺试验、钡剂灌肠和膀胱造影、膀胱镜检查和结肠膀胱镜检查，以及计算机断层扫描和核医学扫描等染料研究作为诊断手段的情况。简要回顾了结肠膀胱瘘的外科治疗。由于结肠膀胱瘘被认为在已知患有憩室病的患者中发生率为2%至22%，因此对所有复发性尿路感染患者，尤其是那些已知患有结肠疾病的患者，询问其终末气尿和粪尿症状是合理的。
