Volume 28, Issue 150, August 2024

Difficulties in the clinical diagnosis of intestinal-vesical fistula: A review

Anna Józefiak1, Magdalena Szczepanik², Cezary Bochyński³, Dominika Kropidłowska⁴, Maciej Horbaczewski⁵, Jolanta Mazurek⁶, Gabriela Mazurek⁷, Patryk Góralski^8♦

¹Department of Internal Diseases and Endocrinology, Gabriel Narutowicz Municipal Specialist Hospital in Cracow, Prądnicka 35-37, 31-202 Cracow, Poland
²Department of Pediatrics, District Hospital in Chrzanów, Topolowa 16, 32-500 Chrzanów, Poland
³Department of Internal Medicine, Railway Hospital. Włodzimierz Roefler, MD, PhD in Pruszków, Warsztatowa 1, 05-800 Pruszków, Poland
⁴Polish Red Cross Maritime Hospital in Gdynia, Powstania Styczniowego 1, 81-519 Gdynia, Poland
⁵Hospital Emergency Department, District Health Center Kartuzy, Floriana Ceynowy 7, 83-300 Kartuzy, Poland
⁶Primary Health Care, Private health care facility "ALMUS" Jacek Pieniazek, Białoboki 137, 37-207 Gać, Poland
⁷Department of Cardiology and Internal Diseases, Gabriel Narutowicz Municipal Specialist Hospital in Cracow, Prądnicka 35-37, 31-202 Cracow, Poland
⁸University Clinical Center in Gdańsk, Dębinki 7, 80-952 Gdańsk, Poland

^♦Corresponding Author
University Clinical Center in Gdańsk, Dębinki 7, 80-952 Gdańsk, Poland

ABSTRACT

Introduction: An intestinal-vesical fistula, also known as an enterovesical fistula, is an abnormal connection between the intestine and the bladder. This pathological connection allows the contents of the intestine to pass the bladder and can cause various symptoms and complications. The aim: The aim of this case report is to present the diagnosis of an entero-vesical fistula in a patient. Case report: 71-yearold female presented with recurrent abdominal and lower back pain, anemia with an Hb level of 9.2 g/dl, a 10kg weight loss over 2.5 months, and recurrent UTIs over two months, unresponsive to ciprofloxacin, amoxicillin, and fosfomycin. Results: After the diagnosis of an intestinal-vesical fistula, the woman was transferred to the Department of General Surgery for bladder wall reconstruction and after that she will remain under the supervision of the urology clinic. Conclusions: The patient's symptoms like abdominal and lower back pain, significant weight loss, anemia, and unresponsiveness to antibiotics suggest the possibility of fistula. More advanced diagnostic evaluation, including imaging and cystoscopy, to confirm the diagnosis and initiate a suitable treatment plan. The prognosis is influenced by the root cause and the patient's general health condition. Surgical intervention commonly has good outcomes, although the complexity of the condition can vary significantly based on the cause and extent of the entero-vesical fistula.

Keywords: Fistula, intestinal-vesical fistula, UTI

Medical Science, 2024, 28, e120ms3419

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DOI: https://doi.org/10.54905/disssi.v28i150.e120ms3419

Published: 30 August 2024