What is the role of barium enema (BE) 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

Barium enema (BE) imaging is unreliable in revealing a fistula but is useful in differentiating diverticular disease from cancer. BE imaging can demonstrate the nature and extent of colonic disease. In a 1988 series, Woods et al used BE imaging to demonstrate fistulae in 42% of cases. [43]

Radiography of centrifuged urine samples obtained immediately after a nondiagnostic BE, called the Bourne test, may enhance the yield of the BE. Barium detected in the urine sediment confirms the presence of a fistula. In one study, the Bourne test results were positive in 9 of 10 patients. In 7 of these patients, the Bourne test finding was the only evidence of an otherwise occult colovesical fistula. [44]


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