Enterovesical Fistulae: Etiology, Diagnosis and Treatment

Abstract

Normally, the urinary system is completely separated from the alimentary canal. Enterovesical fistula (EVF) is an abnormal communication between the intestine and the bladder. Based on the bowel segment involved, it can be divided into four main categories: colovesical (the commonest form, usually between sigmoid colon and bladder dome), rectovesical, ileovesical and appendicovesical (accounting for less than 5% of cases). Enterovesical fistulae are an uncommon complication of both benign and malignant processes. The diagnosis of EVF may, however, be challenging. With a high index of suspicion for fistula formation in patients presenting with symptoms suggestive of abnormal communication between the intestine and the bladder, appropriate radiological investigation can lead to a significant reduction in morbidity. Recognition of a fistulous tract, delineation of its course, and characterisation of its complexity affect the EVF management.