一名年轻成人因计算机断层扫描未检测出的乙状结肠憩室炎导致结肠膀胱瘘：病例报告及文献复习
Colovesical fistula in a young adult due to sigmoid colon diverticulitis undetected in computed tomography: Case report and review of literature.
作者信息
da Silva Barroso Francisco Marcos, Dorgam Maués Carolina Augusta, Lopes de Castro Gustavo, da Silva Galvão Renato, Guedes Saint Clair José Paulo, Riberio Aref Kzam Laura
机构信息
Urology Service at Hospital e Pronto-Socorro 28 de Agosto, Avenida Mário Ypiranga, 1581, Adrianópolis, Manaus, Amazonas, 69057-000, Brazil.
General Surgery Service at Hospital e Pronto-Socorro 28 de Agosto, Avenida Mário Ypiranga, 1581, Adrianópolis, Manaus, Amazonas, 69057-000, Brazil.
出版信息
Ann Med Surg (Lond). 2021 Aug 5;69:102658. doi: 10.1016/j.amsu.2021.102658. eCollection 2021 Sep.
INTRODUCTION
Colovesical fistula is the pathological communication between the colon and urinary bladder. It is related with high morbimortality rate and it is and uncommon complication of diverticulosis in young adults.
CASE PRESENTATION
We report a case of a 38-year-old Brazilian man with fecaluria and pneumaturia for eight months, whose colovesical fistula was undetectable in CT scan and with surgical management.
DISCUSSION
Diverticulosis is the main inflammatory condition causing colovesical fistulas and the sigmoid colon is the most common part involved. It is more prevalent in patients over 60 years old and in western countries due to low fiber diet.
CONCLUSION
Colovesical fistula diagnosis is difficult, requiring high suspicious and proper investigation through good anamnesis, CT scan and also colonoscopy and cystoscopy when necessary.
引言
结肠膀胱瘘是结肠与膀胱之间的病理性通道。它与高病死率相关，是年轻成年人憩室病中一种不常见的并发症。
病例报告
我们报告一例38岁巴西男性，有8个月的粪尿和气尿症状，其结肠膀胱瘘在CT扫描中未被发现，并接受了手术治疗。
讨论
憩室病是导致结肠膀胱瘘的主要炎症性疾病，乙状结肠是最常受累的部位。由于低纤维饮食，它在60岁以上的患者和西方国家更为普遍。
结论
结肠膀胱瘘的诊断困难，需要高度怀疑并通过详细的病史、CT扫描以及必要时的结肠镜检查和膀胱镜检查进行适当的调查。
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