CT in the diagnosis of enterovesical fistulae

Goldman, Stanford M.; Fishman, Elliot K.; Gatewood, Olga M. B.; Jones, Bronwyn; Siegelman, Stanley S.

doi:10.2214/ajr.144.6.1229

Cited by 112 publications

(61 citation statements)

References 17 publications

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“…However, the acute abdominal condition in our patient due to the perforation of the ileovesical fistula necessitated performing emergency surgery, and the diagnosis was reached during the operation. Fistulous communication can be detected by preoperative abdominal tomography, as expected, and its diagnostic rate is 83.3% (7,8). However, we were unable to detect the fistula, and CT scan showed only intraabdominal free air and fluid accumulation.…”

Section: Discussionsupporting

confidence: 55%

Ileovesical fistula secondary to chemotherapy for follicular non-Hodgkin lymphoma: A case report and review of the literature

Karabulut

Akkaya²,

Hoşcan³

et al. 2011

Turk J Gastroenterol

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INTRODUCTIONEnterovesical fistulas are relatively rare complications that can be observed after inflammatory bowel diseases, diverticulitis, colorectal and pelvic malignancies, radiotherapy, and traumas (1,2). To date, particularly in European countries, the most commonly reported underlying cause for this complication is diverticulitis (1). We present a patient who developed an ileovesical fistula while undergoing chemotherapy due to follicular nonHodgkin lymphoma. CASE REPORTA 68-year-old male who had been under chemotherapy (50 mg/m 2 doxorubicin, 750 mg/m 2 cyclophosphamide, 1.4 mg/m 2 vincristine, and prednisone 100 mg -CHOP regimen) for the past two months for follicular non-Hodgkin lymphoma was reevaluated due to his complaints of burning sensation while urinating and abdominal pain for the last one month. Consequently, he developed pneumaturia and fecaluria as he was about to undergo new examinations for those complaints. The pa-

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Section: Discussionsupporting

confidence: 55%

Ileovesical fistula secondary to chemotherapy for follicular non-Hodgkin lymphoma: A case report and review of the literature

Karabulut

Akkaya²,

Hoşcan³

et al. 2011

Turk J Gastroenterol

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“…Nevertheless, contrast resolution of CT still remains less than optimal for the depiction of intestinal fistulae. Based on indirect signs, CT may only suggest the presence of a fistulous tract; however, often without its direct delineation [1,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

et al. 2007

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The diagnostic performance of magnetic resonance imaging (MRI) for detection of intestinal fistulas, other than perianal, in patients with known complicated inflammatory bowel conditions (CIBC) was investigated. Our study group consisted of 20 patients (12 women, mean age 43 years) with CIBC, including Crohn's disease (n=13), colonic diverticulitis (n=3), colitis after radiotherapy (n=3) and of postoperative origin (n=1). Eleven surgically proven enteral fistulas were known in ten (50%) of these patients, being of enterovesical (n=3), enterocolic (n=2), enteroenteral (n=2), rectovaginal (n=2), rectovaginovesical (n=1) and of entercutaneous (n=1) localisation. The other ten patients (50%), used as the control group, showed MR features of CIBC, although without any fistulous tract. Multiplanar T1-and T2-weighted sequences had been performed, including gadolinium-enhanced acquisition with fat saturation (1.5 T). MR findings were independently blindly and retrospectively reviewed by three radiologists for the presence and etiology of any fistula, as well as visualization and characterization of the fistulous tract. Results were compared with surgical findings (n=16) and clinical evolution (n=4). Interobserver agreement was calculated. Interobserver agreement kappa for fistula detection was 0.71. Overall sensitivity, specificity and accuracy for fistula detection were 78.6%, 75% and 77.2%, respectively. Sensitivity for fistula characterization was 80.6%, with visualization of the fistulous tract in all cases, whereby T1-weighted gadolinium-enhanced fat-saturated images were considered the most useful sequences. Gadolinium-enhanced MRI is a reliable and reproducible tool for detection of enteral fistulas secondary to inflammatory conditions.

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“…CT findings of a colovesical fistula are intravesical air with no known prior instrumentation, focal bladder and bowel wall thickening, presence of contrast in the bladder after contrast was administered orally or per rectum, and a paravesical mass. Only occasionally is the actual fistulous tract identified on CT [8,9].…”

Section: Discussionmentioning

confidence: 99%

Imaging features of colovesical fistulae on MRI

Tang

Booth²,

Swallow³

et al. 2012

BJR

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Objectives: MRI is routinely used in the investigation of colovesical fistulae at our institute. Several papers have alluded to its usefulness in achieving the diagnosis; however, there is a paucity of literature on its imaging findings. Our objective was to quantify the MRI characteristics of these fistulae. Methods: We selected all cases over a 4-year period with a final clinical diagnosis of colovesical fistula which had been investigated with MRI. The MRI scans were reviewed in a consensus fashion by two consultant uroradiologists. Their MRI features were quantified. Results: There were 40 cases of colovesical fistulae. On MRI, the fistula morphology consistently fell into three patterns. The most common pattern (71%) demonstrated an intervening abscess between the bowel wall and bladder wall. The second pattern (15%) had a visible track between the affected bowel and bladder. The third pattern (13%) was a complete loss of fat plane between the affected bladder and bowel wall. MRI correctly determined the underlying aetiology in 63% of cases. Conclusions: MRI is a useful imaging modality in the diagnosis of colovesical fistulae. The fistulae appear to have three characteristic morphological patterns that may aid future diagnoses of colovesical fistulae. To the authors' knowledge, this is the first publication of the MRI findings in colovesical fistulae.

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CT in the diagnosis of enterovesical fistulae

Cited by 112 publications

References 17 publications

Ileovesical fistula secondary to chemotherapy for follicular non-Hodgkin lymphoma: A case report and review of the literature

Ileovesical fistula secondary to chemotherapy for follicular non-Hodgkin lymphoma: A case report and review of the literature

Diagnostic performance of MRI for detection of intestinal fistulas in patients with complicated inflammatory bowel conditions

Imaging features of colovesical fistulae on MRI

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