Enterovesical Fistula Secondary to Squamous Cell Carcinoma of the Bladder

Abstract

Enterovesical fistulas are a well-known complication of inflammatory and malignant bowel disease. Bladder carcinoma, however, is an extremely rare etiology. We describe a case of squamous cell carcinoma of the bladder with an enterovesical fistula. This rare phenomenon has never been previously reported in western literature. We review the diagnosis, work up and treatment of enterovesical fistulas. Unfortunately, the prognosis for these highly invasive tumors is very poor and the treatment is often palliative. The high morbidity and mortality makes management of these patients exceptionally challenging.

Enterovesical Fistula Secondary to Transitional Cell Carcinoma of the Bladder

“…7 Inflammation (52%) is the most common pathological process giving rise to an enterovesical fistula followed by neoplasia (35%) and trauma (16%). 2 3 8…”

“…Additionally, in many cases with extensive inflammatory change and tissue necrosis, despite cystoscopy and biopsy, the cause of enterovesical fistula remains elusive and is only established at laparotomy. 2 …”

“… 20 However, the symptomatology is often so devastating that palliative surgical treatment is still attempted in most cases. 2 …”

“…Enterovesical fistula is a pathological passage between part of the intestine and the bladder. 1 2 3 The first ever enterovesical fistula described in the literature dates back to 200 AD; an individual passing urine per rectum. 4 It was in the late 19 th century that enterovesical fistulae became more frequently reported.…”

“… 1 2 3 5 6 However, enterovesical fistulae secondary to primary bladder cancer are extremely rare. 1 2 3 5 6 The diagnosis of an enterovesical fistula can pose a great challenge to the clinician, with the consequence of it being diagnosed several months after symptoms initiate. 1 Here we report a case of an enterovesical fistula secondary to transitional cell carcinoma (TCC) of the bladder fistulating into the ileum and presenting with recurrent urinary tract infections.…”