Rectovesical fistula

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Previous colorectal surgery for a colonic malignancy. Clinical suspicion of a colorectal fistula.

Patient Data

Age: 70 years
Gender: Male
ct

Contrast administered into the rectum.  

A wide fistulous tract at 12 O'clock communicates with the posterior aspect of the urinary bladder.

The bladder is diffusely thick walled.

Case Discussion

Colovesical fistula is a abnormal communication between the colon, typically the rectosigmoid, and the urinary bladder.

The commonest causes are secondary to colonic malignancies and diverticular disease.

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