Wynn Aye Aye, Yin Khine San, Mya Nang Khin, Azizan Nornazirah, Zakaria Andee Dzulkarnaen, Hayati Firdaus
Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
Department of Pathology, University of Medicine 1, Yangon, Myanmar.
Ann Med Surg (Lond). 2022 Jun 11;79:103967. doi: 10.1016/j.amsu.2022.103967. eCollection 2022 Jul.
Colonic diverticulosis is often asymptomatic, but it can complicate bleeding, abscess and stricture. Pneumaturia and faecaluria are unexpected manifestations of colonic diverticulitis complicated by colovesical fistula formation.
This case report highlighted a 57-year-old man who presented with lower abdominal pain which was associated with pneumaturia and fecaluria. He was diagnosed with colovesical fistula after being misdiagnosed with other diseases from various clinic visits. Direct fluoroscopy was performed and a diverticular fistula of the sigmoid colon was confirmed by computed tomography of the abdomen. Hartmann's procedure and resection of the posterior wall of the bladder were resected.
Pneumaturia and faecaluria are common but distinct manifestations of complicated diverticular diseases. Attention should be paid to general practitioners to achieve proper referral, hence early treatment and prevention of disease-related complications.
结肠憩室病通常无症状,但可并发出血、脓肿和狭窄。气尿和粪尿是结肠憩室炎并发结肠膀胱瘘形成的意外表现。
本病例报告重点介绍了一名57岁男性,他出现下腹痛并伴有气尿和粪尿。在多次门诊被误诊为其他疾病后,他被诊断为结肠膀胱瘘。进行了直接荧光透视检查,腹部计算机断层扫描证实乙状结肠有憩室瘘。行哈特曼手术并切除膀胱后壁。
气尿和粪尿是复杂憩室疾病常见但独特的表现。全科医生应予以关注,以实现正确转诊,从而早期治疗并预防疾病相关并发症。