Colovesical fistula presenting with epididymitis

This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient repor...

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Bibliographic Details
Published in:BMJ case reports 2013-04, Vol.2013, p.bcr2013009291
Main Authors: Arneill, Matthew, Hennessey, Derek Barry, McKay, Damian
Format: Article
Language:English
Subjects:
Abdomen
Aged
Anti-Bacterial Agents - therapeutic use
Aortic aneurysms
Bladder
Colon
Diagnosis, Differential
Diverticulitis
Drug Therapy, Combination
Epididymitis - diagnosis
Epididymitis - drug therapy
Fistula
Humans
Intestinal Fistula - diagnosis
Intestinal Fistula - drug therapy
Male
Pain
Sepsis
Surgical anastomosis
Tomography, X-Ray Computed
United Kingdom
Unusual Presentation of More Common Disease/Injury
Urine
Urogenital system
White
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Summary:This article reports a case of colovesical fistula presenting with epididymitis. A 75-year-old man with a recent conservatively managed localised diverticular perforation presented to hospital with acute pain and swelling of his left testicle and epididymis. On further questioning, the patient reported passing air in his urine. Urine cultures grew Enterococcus faecalis. Ultrasound scan confirmed a diagnosis of bacterial epididymitis and the patient was treated with intravenous antibiotics. Subsequent CT imaging revealed air in the bladder and a colovesical fistula. The patient went on to have Hartmann's procedure with repair of the bladder defect. This case highlights that: (1) Colovesical fistulae may rarely present with epididymitis. (2) Colovesical fistulae are the most common cause of pneumaturia.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2013-009291