Treatment of Vesico-enteric Fistula
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Vesico-enteric fistula, also known as vesico intestinal, is characterized by a hole that develops between the bowel and the intestine. “Fistula” is a general term for a hole that develops in some part of the body and can occur following surgery of the intestinal tract if it does not grow back together properly.
A fistula can also develop in people who overstrain their muscles or have problems with muscle tone. People who are overweight have a predisposition for muscle weakness, because visceral fat in the abdominal area takes away the initial strength of the abdominal muscles. Weightlifting can also cause a person to develop a vesico-enteric fistula, especially if they lift objects heavier than their own weight. Manual labor and child birth can also overstrain the lower abdominal muscles and cause problems later on.
A vesico-enteric fistula can also result from intestinal diseases, such as diverticulitis or colorectal cancer. Diverticulitis is the inflammation of the diverticulum. According to statistics, 60% of all vesico-enteric fistula cases are caused by diverticulitis and another 10% are caused by colorectal cancer. Crohn’s disease can also lead to the development of a vesico-enteric fistula, as can undergoing radiotherapy, appendicitis or trauma to the lower abdominal area.
- Gas, or air, in the urine
- Feces and urine are mixed together, due to the hole
- Discomfort or pain in the lower abdomen
- Diarrhea or constipation
- Pain when urinating
- During a general examination, the doctor will inquire about the patient’s medical history, specifically asking about any intestinal diseases. This should help to rule out any other causes of abdominal pain.
- The doctor will internally examine the patient’s genitals and rectum.
- An ultrasound can be useful when examining the bowel and intestines. Any sign of a fistula, diverticulitis or other diseases of the intestinal tract should show up.
- Other imaging tests, such as a CT or MRI scan, can give doctors a clear picture of the intestines, so that they can rule out other conditions.
- A biopsy is performed if there is a suspicion of malignancy.
- A blood test can rule out the possibility of an infection.
- Operational closure is a surgical procedure whereby the fistula is repaired. Surgeons may be able to correct any other intestinal problems at the same time, and prevent any blood leakage.
- The patient will need to take things easy during the recovery period, to prevent the hole from reopening.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko