Laparoscopic diagnosis of appendicovesical fistula in a pediatric patient.

Appendicovesical fistula is a rare complication of acute appendicitis in children that is difficult to diagnose preoperatively. A 21-month-old boy with signs and symptoms of recurrent urinary tract infections underwent abdominal ultrasonography, computed tomography (CT), barium enema examination, and cystography, none of which was sufficient to establish a diagnosis; an appendicovesical fistula was demonstrated by laparoscopy. The patient underwent open appendectomy, with resection of the fistula through a small incision, and has recovered without complications.