What is the pathophysiology of malignant enterovesical fistula?

Updated: Dec 24, 2020
  • Author: Joseph Basler, MD, PhD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Malignancy accounts for up to 20% of vesicoenteric fistulae and is the second most common cause of enterovesical fistula. Rectovesical fistula is the most common presentation, as rectal carcinoma is the most common colonic malignancy resulting in fistula formation. [19] Transmural carcinomas of the colon and rectum may adhere to adjacent organs and may eventually invade directly, causing development of a fistula. Transitional cell carcinoma of the bladder is the next most common malignancy-related pathology. [20] Occasionally, carcinomas of the cervix, prostate, and ovary are implicated, and incidents involving small-bowel lymphoma have been reported. [21]

Although malignancy is the second most common cause of enterovesical fistula formation, such cases have become uncommon because most carcinomas are diagnosed and treated prior to this advanced stage.


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