Colovesical fistula in a young adult due to sigmoid colon diverticulitis undetected in computed tomography: Case report and review of literature

• Published in: Annals of medicine and surgery 2021-09, Vol.69, p.102658, Article 102658
• Main Authors: da Silva Barroso, Francisco Marcos, Dorgam Maués, Carolina Augusta, Lopes de Castro, Gustavo, da Silva Galvão, Renato, Guedes Saint Clair, José Paulo, Riberio Aref Kzam, Laura
• Format: Article
• Language: English
• Subjects: Case Report; Colovesical fistula; Diverticulosis; Enterectomy; Fistula; Sigmoid colon; Urinary bladder
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102658

Colovesical fistula is the pathological communication between the colon and urinary bladder. It is related with high morbimortality rate and it is and uncommon complication of diverticulosis in young adults. We report a case of a 38-year-old Brazilian man with fecaluria and pneumaturia for eight months, whose colovesical fistula was undetectable in CT scan and with surgical management. Diverticulosis is the main inflammatory condition causing colovesical fistulas and the sigmoid colon is the most common part involved. It is more prevalent in patients over 60 years old and in western countries due to low fiber diet. Colovesical fistula diagnosis is difficult, requiring high suspicious and proper investigation through good anamnesis, CT scan and also colonoscopy and cystoscopy when necessary. •Colovesical fistula is an uncommon disorder in young adults and it is more frequently in western countries.•Diverticulits is the main inflammatory condition causing enterovesical fistulas and the sigmoid colon the most common.•Colovesical fistula diagnosis is difficult, requiring proper investigation through CT scan or other exams.•Most cases of colovesical fistula are diagnosed during surgery approach and surgically managed.