What is the role of lab studies in the workup of enterovesical fistula?

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

Urinalysis usually shows a full field of white blood cells, bacteria, and debris. A variant of the Bourne test (see Bourne test) using orally administered charcoal is also helpful. Charcoal in the urine is detected either visually or microscopically in the centrifuged urine. [35]

Urine culture findings are typically interpreted as mixed flora, although the most common organism identified is Escherichia coli. In the setting of sepsis, attempts should be made to characterize the predominant organisms and to obtain sensitivities to guide further therapy. Recurrent UTIs with various organisms are consistent with, but not diagnostic of, enterovesical fistulae.

Blood studies should include measurement of the blood urea nitrogen (BUN), creatinine, and electrolytes; findings are typically within the reference range. The results of the complete blood cell count (CBC) are typically normal. Leukocytosis may be found in cases associated with focal areas of undrained abscess or development of florid cystitis or pyelonephritis. Anemia may be present in patients with chronic disease and may be associated with malignancy.


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