Jarrett T W, Vaughan E D
Department of Urology, James Buchanan Brady Foundation, New York Hospital-Cornell Medical Center, New York.
J Urol. 1995 Jan;153(1):44-6. doi: 10.1097/00005392-199501000-00018.
We reviewed 9 consecutive patients with colovesical fistula secondary to diverticulitis during a 2-year period. Preoperative evaluation included computerized tomography (CT) and a barium enema or colonoscopy in all patients (8 underwent cystoscopy). All patients subsequently underwent laparotomy with a single or multiple staged repair. Using CT criteria for diagnosis of colovesical fistulas, the study accurately predicted the presence and location of fistula in 8 patients, and was suspicious in 1. Findings at cystoscopy only diagnosed 3 fistulas and were suspicious in 4. The remaining diagnostic tests, including excretory urography, barium enema, abdominal plain films, colonoscopy and cystogram, were unremarkable except for a single cystogram and barium enema. In addition to documenting the fistula, CT provided important intraluminal and extraluminal pathological findings helpful in planning subsequent surgery. Thus, CT should be included in the initial evaluation of patients with suspected colovesical fistula.
我们回顾了2年间9例因憩室炎继发结肠膀胱瘘的连续病例。所有患者均进行了术前评估，包括计算机断层扫描（CT）以及钡灌肠或结肠镜检查（8例接受了膀胱镜检查）。所有患者随后均接受了剖腹手术，采用单次或多阶段修复。使用CT诊断结肠膀胱瘘的标准，该研究准确预测了8例患者瘘管的存在和位置，1例可疑。膀胱镜检查结果仅诊断出3例瘘管，4例可疑。其余诊断检查，包括排泄性尿路造影、钡灌肠、腹部平片、结肠镜检查和膀胱造影，除1例膀胱造影和钡灌肠外均无异常。除记录瘘管外，CT还提供了重要的腔内和腔外病理结果，有助于规划后续手术。因此，对于疑似结肠膀胱瘘的患者，初始评估应包括CT检查。
