Skierucha M, Barud W, Baraniak J, Krupski W. Colovesical fistula as the initial manifestation of advanced colon cancer: A case report and review of literature. World J Clin Cases 2018; 6(12): 538-541 [PMID: 30397610 DOI: 10.12998/wjcc.v6.i12.538]
Corresponding Author of This Article
Małgorzata Skierucha, MD, Doctor, Department of Internal Diseases, Medical University of Lublin, Staszica 11, Lublin 20-081, Polen (POL), Poland. malgorzata.skierucha@gmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 26, 2018; 6(12): 538-541 Published online Oct 26, 2018. doi: 10.12998/wjcc.v6.i12.538
Colovesical fistula as the initial manifestation of advanced colon cancer: A case report and review of literature
Małgorzata Skierucha, Wojciech Barud, Jerzy Baraniak, Witold Krupski
Małgorzata Skierucha, Wojciech Barud, Jerzy Baraniak, Department of Internal Diseases, Medical University of Lublin, Lublin 20-081, Polen (POL), Poland
Witold Krupski, Department of Radiology, Medical University in Lublin, Lublin 20-081, Polen (POL), Poland
Author contributions: Skierucha M and Barud W made equal contribution in the study concept, collecting data and writing the paper. Baraniak J and Krupski W took part in diagnostics and provided imaging data.
Informed consent statement: Written informed consent to colostomy was obtained from the patient before the operation.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Małgorzata Skierucha, MD, Doctor, Department of Internal Diseases, Medical University of Lublin, Staszica 11, Lublin 20-081, Polen (POL), Poland. malgorzata.skierucha@gmail.com
Telephone: +48-81-5327717 Fax: +48-81-5327717
Received: July 4, 2018 Peer-review started: July 4, 2018 First decision: August 20, 2018 Revised: September 13, 2018 Accepted: October 10, 2018 Article in press: October 10, 2018 Published online: October 26, 2018 Processing time: 114 Days and 23.8 Hours
ARTICLE HIGHLIGHTS
Case characteristics
Misinterpretation of diarrhea in a female patient with a colovesical fistula (CVF) due to an advanced colon cancer.
Clinical diagnosis
Acute diarrhea, recurring fever, abdominal cramps, nausea and a lack of appetite.
Differential diagnosis
Infectious diarrhea.
Laboratory diagnosis
Hypokalemia, hypoalbuminemia, leukocytosis with a predominance of granulocytes and elevated C-reactive protein. Bacteriuria and leukocyturia in urinalysis.
Imaging diagnosis
A computed tomography scan revealed a heterogeneous tumor, enlarged lymph nodes in the pelvis and metastases in the liver and peritoneum. Cystography showed a CVF.
An urgent colostomy conducted because of a bowel obstruction.
Related reports
Wei et al have described a case of a male patient with CVF, whose symptoms were comparable to those described in our case. However, to our limited knowledge, this is the first case report describing CVF in a female.
Term explanation
CVF is a pathologic junction between the bladder and colon. Approximately 20%-30% of CVFs develop as complications of advanced tumors of the abdominal or pelvic cavity.
Experiences and lessons
Diarrhea may be a misleading symptom of CVF. A basic test such as urinalysis should never be neglected. In our case, repeated urinalysis may have been very informative. Patients with diarrhea of unknown reason should be catheterized to control the renal loss of fluids and the quality of urine.
