Laparoscopic treatment of a vesicointestinal fistula due to a Meckel’s diverticulum: a case report and review of the literature

• Published in: Clinical journal of gastroenterology 2018-12, Vol.11 (6), p.476-480
• Main Authors: Hakoda, Hiroyuki, Mishima, Hideyuki, Habu, Takumi, Murai, Shin, Maeno, Ryohei, Yokomizo, Yuriko, Inagaki, Yuki, Maruyama, Takehito, Matsui, Yuichi, Sako, Akihiro
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Case Report; Colorectal Surgery; Gastroenterology; Hepatology; Medicine; Medicine & Public Health; Surgical Oncology
• ISSN: 1865-7257; 1865-7265
• DOI: 10.1007/s12328-018-0878-9

While there have been numerous reports about colovesical fistulas and ruptured intestinal diverticula, there have been far fewer reports about vesicointestinal fistulas caused by Meckel’s diverticula. Most Meckel’s diverticula are asymptomatic. Furthermore, they seldom cause vesicointestinal fistulas, and the associated complications are non-specific. Thus, their preoperative diagnosis is difficult. We experienced a case in which a vesicointestinal fistula was caused by a Meckel’s diverticulum and was treated with laparoscopic surgery. A 46-year-old male was referred to our hospital after exhibiting hematuria. Cystoscopy revealed a fistula between the small intestine and bladder. Contrast-enhanced computed tomography and magnetic resonance imaging showed a diverticulum in the ileum and a fistula between the ileum and bladder, which passed through the diverticulum. A Meckel’s diverticulum was suspected. We conducted a laparoscopic operation. We dissected the Meckel’s diverticulum with an automatic suturing device and removed it together with part of the ileum. The patient’s postoperative course was good. We experienced a case in which a vesicointestinal fistula was caused by a Meckel’s diverticulum and was successfully treated with laparoscopic surgery. In selected cases of Meckel’s diverticulum, the dissection of the diverticulum with an automatic suturing device is appropriate.