Rapi S, Bonari A, Dugheri S, Cappelli G, Trevisani L, Milletti E, Mucci N, Arcangeli G, Morettini A, Fanelli A
General Laboratory, Careggi University Hospital, Florence, Italy.
Industrial Toxicology Laboratory, Careggi University Hospital, Florence, Italy.
Pract Lab Med. 2021 Sep 1;27:e00255. doi: 10.1016/j.plabm.2021.e00255. eCollection 2021 Nov.
Colovesical fistula (CVF) is an abnormal connection between the colon and the urinary bladder. Faecaluria, reported in 40-70% of cases, is virtually pathognomonic for CVF. During the 5th day of recovery in an 84 years old subject, the passage of cloudy, malodorous urine with visible debris was observed. According to the pathognomonic character of faecaluria, the sample was signed to the laboratory for biochemical and microbiological investigation, able to define the type and origin of materials. Following clinical requirements, both biochemical pathways and instrumental procedures able to confirm or exclude the presence of faecal components in urine were considered. No biochemical compound or component addressing faecal compounds in urine results available between laboratory tests. The brown powder component of the pellet was identified as Keratin, with 90% overlapping with the reference spectrum of the compound. FT-IR analysis on urine pellet can be proposed as a simple, non-invasive, and fast method to improve the diagnostic course of CVF.
结肠膀胱瘘（CVF）是结肠与膀胱之间的异常连接。40%至70%的病例报告有粪尿症，这实际上是CVF的特征性表现。在一名84岁患者恢复的第5天，观察到排出浑浊、有异味且带有可见残渣的尿液。根据粪尿症的特征性表现，将样本送至实验室进行生化和微生物学检查，以确定物质的类型和来源。根据临床需求，考虑了能够确认或排除尿液中粪便成分存在的生化途径和仪器检查方法。实验室检测之间没有可用于确定尿液中粪便化合物的生化化合物或成分结果。沉淀物中的棕色粉末成分被鉴定为角蛋白，与该化合物的参考光谱有90%的重叠。可以提出对尿沉淀物进行傅里叶变换红外光谱（FT-IR）分析，作为一种简单、无创且快速的方法来改善CVF的诊断过程。
