VESICO-SIGMOID FISTULA (CASE REPORT)
Vesico-sigmoid fistula is the fistula between the bladder and sigmoid colon. One of the reasons for the development of this pathology is sigmoid colon cancer. Fistula formation is based on the invasion of sigmoid colon cancer into bladder wall, its destruction and formation of connection between these organs. Approximately 0.6% of colon cancer complicates by Colo-vesicular fistula. With a male-to-female ratio 3:1. Nowadays, Due to ability of early, high-tech investigation of colon, sigmoid colon cancer is diagnosed at an earlier stage, therefore frequency of such complication, as vesico-sigmoid fistula is reduced. In case of vesico-sigmoid fistula, due to the pressure gra- dient, as a rule, the content of the colon enters the bladder and clinical signs of urinary tract infection are present, this is the main reason for patients to visit a doctor. The treat- ment of choice is surgery. A case of vesico-sigmoid fistula developed through invasion of colon adenocarcinoma in to the posterior wall of the bladder has been presented. The patient was admitted to the hospital in septic condition, with suprapubic pain, disuria, tenesmus. Clinical studies revealed sigmoid colon cancer, vesico-sigmoid fistula. Due to poor condition of the patient, transversostomy was performed, 3 weeks later – radical surgery - excision of the tumor and vesico-sigmoid fistula closure. Colostoma was closured in 6,5 month.
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