Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2022; 10(10): 3241-3250
Published online Apr 6, 2022. doi: 10.12998/wjcc.v10.i10.3241
Appendico-vesicocolonic fistula: A case report and review of literature
Han Yan, Ying-Chao Wu, Xin Wang, Yu-Cun Liu, Shuai Zuo, Peng-Yuan Wang
Han Yan, Ying-Chao Wu, Xin Wang, Yu-Cun Liu, Shuai Zuo, Peng-Yuan Wang, Department of General Surgery, Peking University First Hospital, Beijing 100032, China
Author contributions: Yan H reviewed the literature and contributed to data collection and manuscript drafting; Wu YC and Zuo S were the patient’s surgeons and were responsible for the revision of the manuscript; all other members equally contributed to the medical treatment and manuscript drafting.
Informed consent statement: Informed written consent was obtained from the patient’ parents for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Yuan Wang, MD, Doctor, Department of General Surgery, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing 100032, China. wangpengyuan2014@126.com
Received: October 10, 2021
Peer-review started: October 10, 2021
First decision: December 12, 2021
Revised: December 30, 2021
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: April 6, 2022
Processing time: 170 Days and 8.6 Hours
Abstract
BACKGROUND

Appendico-vesicocolonic fistulas and appendiceal-colonic fistulas are two kinds of intestinal and bladder diseases that are rarely seen in the clinic. To our knowledge, no more than 4 cases of appendico-vesicocolonic fistulas have been publicly reported throughout the world, and no more than 100 cases of appendiceal-colonic fistulas have been reported. Although the overall incidence is low, an early diagnosis is difficult due to their atypical initial symptoms, but these diseases still require our attention.

CASE SUMMARY

Here, we report a case of a 77-year-old male patient diagnosed with an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula. The main manifestations were diarrhea and urine that contained fecal material. The diagnosis was confirmed by multiple laboratory and imaging examinations. A routine urinalysis showed red blood cells and white blood cells. Abdominal and pelvic computed tomography scans showed close adhesions between the bowels and the bladder, and fistulas could be seen. Colonoscopy and cystoscopy and some other imaging examinations clearly showed fistulas. The preoperative diagnoses were a colovesical fistula and an appendiceal-colonic fistula. The fistulas were repaired by laparoscopic surgical treatment. The diseased bowel and part of the bladder wall were removed, followed by a protective ileostomy. The postoperative diagnosis was an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula, and the pathology suggested inflammatory changes. The patient recovered well after surgery, and all his symptoms resolved.

CONCLUSION

The final diagnosis in this case was a double fistula consisting of an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula.

Keywords: Appendico-vesicocolonic; Appendiceal-colonic; Enterovesical; Fistula; Laparoscopic surgery; Case report

Core Tip: Appendico-vesicocolonic fistulas and appendicovesical fistulas are rare diseases involving the intestine and urinary bladder. These conditions have a very low morbidity even in patients with appendicitis after conservative treatment or with malignant tumors. Early symptoms and signs are usually atypical, making early diagnosis and treatment more difficult. Here, we present a case of an appendico-vesicocolonic fistula combined with an appendiceal-colonic fistula and provide some recommendations for diagnosis and treatment along with a review of the literature.