Mbaeri Timothy Uzoma, Nwadi Uchenna Victor, Onu Onyekachi Amos
Division of Urology, Department of Surgery, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Niger Med J. 2023 Feb 24;63(5):432-437. eCollection 2022 Sep-Oct.
Enterovesical fistula represents an abnormal communication between the urinary bladder and the gastrointestinal tract. It can result spontaneously from different disease processes, but can also complicate a surgical procedure. While most involve the large bowel, few involve the small bowel and these present with more clinical problems, as well as challenges in diagnosis and management. The patient is a 50-year-old P , woman who presented to our facility with a 6 months' history of faecaluria. There was associated history of urinary frequency, urgency, pneumaturia and dysuria. She had subtotal hysterectomy 6 years prior to presentation. Cystography, Abdominal computed tomography scan, and cystoscopy done revealed a small bowel fistula with the bladder. She had exploratory laparotomy which revealed the fistula and extensive intra-abdominal nylon suturing of bladder and jejunum. She was treated and did well postoperatively. Enterovesical fistula can follow wrong suture use in surgical procedures even many years after the procedure. A high index of suspicion and imaging modalities are needed for early diagnosis and prompt management.
膀胱肠道瘘是指膀胱与胃肠道之间出现异常通道。它可由不同疾病过程自发形成，也可能是外科手术的并发症。虽然大多数病例涉及大肠，但少数涉及小肠，而这些病例会带来更多临床问题，以及诊断和管理方面的挑战。患者为一名50岁女性，因有6个月的粪尿病史前来我院就诊。伴有尿频、尿急、气尿和排尿困难的病史。她在就诊前6年接受了子宫次全切除术。膀胱造影、腹部计算机断层扫描和膀胱镜检查显示存在小肠与膀胱的瘘管。她接受了剖腹探查术，术中发现瘘管，并对膀胱和空肠进行了广泛的腹腔内尼龙缝合。她接受了治疗，术后恢复良好。膀胱肠道瘘甚至可在手术多年后因手术中缝线使用不当而发生。早期诊断和及时处理需要高度的怀疑指数和影像学检查手段。
