Vesicocutaneus fistula after cesarean section-a curious complication: Case report and review

Post-operative vesicoenterocutaneous fistula with multiple intestinal knotting: A case report

Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of urine but later urine mixed with faeces from the lower abdomen after two previous abdominal surgeries. He had an open transvesical prostatectomy due to benign prostate enlargement complicated by leakage of urine from lower abdominal wall scar. A repeat surgical intervention to correct the urine leakage was followed by recurrence of urine leakage and later by leakage of feculent urine from the lower anterior abdominal wall. At our facility, he had exploratory laparotomy with manual unknotting of ileal loops, fistula tracts excision, resection, and end-to-end ileoileal anastomosis. The bladder wall was repaired with suprapubic cystostomy. Although the finding of asymptomatic multiple small bowel knotting was incidental in the index case, its timely management averted a sitting timed bomb that may lead to a diagnostic dilemma with catastrophic consequences.

Doppler ultrasound contribution in vesico-peritoneal and vesico-cutaneous fistulas diagnosis: two case reports of a new sign

Background

Report cases of vesico-peritoneal and vesico-cutaneous fistulas suspected to Doppler ultrasound confirmed by CT scan/conventional cystography and successfully treated.

Case presentation

Two male patients of 35- and 36-year-old, without any medical past history, had presented anuria and absence of miction respectively after a road traffic accident and a piece of wood penetrating the left thigh. The physical examination revealed lower limbs hematoma and severe abdominal pain in the man of 35 years and a sutured wound of the left thigh of 4 cm with a bright liquid flowing from it with the characteristic smell of urine in the man of 36 years. A Doppler ultrasound was made. The Doppler had shown normal ureteral jets but with a third abnormal flux which went from interior to exterior of the urinary bladder for the first patient and from the bladder to the left inguinal cutaneous tissue for the second patient. The treatment was a Foley’s catheter into the bladder with antibiotics in the two cases after excision and separate suture of the peritoneum and bladder during umbilical laparotomy in the first case. The suites were simples.

Conclusions

The diagnostic contribution of CT/conventional cystography is well known and undisputed, but for Doppler ultrasound, it is anecdotal like in these cases we report. Nevertheless, there is a need to evaluate the semiological value of Doppler ultrasound contribution on a greater sample.

Urinary bladder fistulae and the role of CT cystography: a pictorial review

Various conditions such as inflammation, malignancy, surgical manipulations, and radiation therapy can lead to the development of urinary bladder fistulae. Although many of these fistulae are suspected clinically, imaging plays a major role in confirmation and planning of subsequent treatment. Computed tomography (CT) cystoscopy provides useful details regarding the fistulous track and the anatomy of the region. This article aims to provide a succinct review of bladder fistulae and the role of CT cystography in their management.

Post-traumatic bilateral vesicocutaneous fistula of thighs treated with buccal mucosa graft urethroplasty and cyanoacrylate glue instillation: a novel treatment for management of a complicated fistula

Post-traumatic vesicocutaneous fistula (VCF) is a rare variant of urinary fistulas. These fistulas may externally communicate to abdomen, perineum, buttocks, scrotum or very rarely thigh. These fistulas usually develop at a variable time duration after trauma and are usually preceded with thigh swelling or abscess formation followed by spontaneous rupture. We, hereby, report a case of VCF of bilateral thighs with associated penobulbar urethral stricture after road traffic accident which was managed with dual modality of buccal mucosa graft urethroplasty surgery and cyanoacrylate glue injection in the fistulous tracts. To the best of our knowledge, this is first report of bilateral VCFs communicating externally to thighs. In literature, very few cases of VCFs of thigh are reported and are rarely managed with adhesive glue application.