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Jornal brasileiro de nefrologia : orgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia

[Recurrent urinary tract infection due to enterovesical fistula secondary to colon diverticular disease: a case report].

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Natália Silva Cavalcanti
Lorena Luryann Cartaxo da Silva
Leonardo Sales da Silva
Luiz Antonio Cavalcante da Fonseca
Cristianne da Silva Alexandre

Sleutelwoorden

Abstract

BACKGROUND

Enterovesical fistula are pathological connections between the bladder and pelvic intestinal segments. It consists of a rare complication of neoplastic and inflammatory pelvic disorders, in addition to iatrogenic or traumatic injuries, and correlates with both high morbidity and mortality indexes.

METHODS

Male patient, 61 years old, admitted at the hospital clinics featuring abdominal pain and distension, vomiting and fecal retention. Patient's pathological precedents include high blood pressure, diabetes mellitus, vesical dysfunction and recurrent urinary tract infection on the past three years. Magnetic resonance imaging of abdomen and pelvis revealed enterovesical fistula in association with colon diverticular disease of the sigmoid. Management of choice consisted of partial colectomy with bowel lowering and partial cystectomy with surgical double-J stent insertion.

CONCLUSIONS

Although consisting of a gastrointestinal primary affection, patients with enterovesical fistula usually search for medical help charging urinary tract features. In this particular case, our patient was admitted with gastrointestinal symptoms, reasoned by diagnostic delay, as the patient had already attended at multiple centers with urinary symptoms.

CONCLUSIONS

Despite being an unusual affection, recurrent urinary tract infection associated with colon diverticular disease must always be considered at differential diagnosis of recurrent urinary tract infection as it concurs with high morbidity and mortality.

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