MALIGNANT ENTERO-VESICAL FISTULAS

Malignant entero-vesical fistulas are uncommon. Colonic malignancy is the main cause althouht fistula are present in justg 1 %. Pneumaturia and fecaluria are pathognomonic for entero-vesico-fistula and are pres ent in half of cases, By combining the results of cystoscopy, barium e nema and urine culture, fistula can be identified in almost all the ca ses. Escherichia coli, Streptococcus faecalis and Proteus mirabilis ar e very often isolated from the urine cultures. The management of enter o-vesical-fistula depends of the etiology. The treatment requires in m ost of the case resection of the diseased bowel with partial cystectom y and primary anastomosis. But sometimes, is necessary to perform a di verting colostomy and urinary diversion.