What is the anatomy of the intestinal segments relevant to enterovesical fistula?

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

Fistula formation is believed to evolve from a localized perforation to which an adjacent viscus adheres. The pathologic process is almost always intestinal and characteristic to particular intestinal segments that adhere to the bladder. The segments most commonly in proximity to the bladder include the rectum, sigmoid colon, ileum, jejunum, and appendix.

Furthermore, the segment of bowel that is involved can suggest the intestinal pathology. Colovesical fistulae primarily result from sigmoid diverticular disease. Ileovesical fistulae are most likely associated with Crohn disease. Rectovesical fistulae are more commonly due to trauma, surgery, or malignancy. Appendicovesical fistulae tend to be associated with a history of appendicitis.


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