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Case Reports: Unusual association of diseases/symptoms
Unique case of colovesical fistula in a renal allograft recipient
  1. Supradeep Narayanaswamy,
  2. Rajvi Goradia,
  3. Sachin Bhujbal and
  4. Sujata Patwardhan
  1. Urology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
  1. Correspondence to Dr Supradeep Narayanaswamy; vidvathpriya{at}gmail.com

Abstract

Colovesical fistula is commonly suspected in cases of diverticular disease, malignancy, trauma, iatrogenic injury or radiotherapy. In a case of allogenic live related transplant, this is rarely expected, especially after 20 years. The presence of gas in the bladder in the absence of history of instrumentation of urinary tract should prompt us to evaluate for colovesical fistula. Pneumaturia, faecaluria and recurrent urinary tract infection are tell-tale features of colovesical fistula, and when patients who are renal allograft recipient present with them, it should prompt a proper workup and swift surgical management, since the outcome is uniformly favourable. From our knowledge in this realm, we know that these are immunocompromised patients and have a high tendency to develop risk factors like malignancy and/or diverticular disease and eventually form colovesical fistula. An expected time period could be from 2 months to 6 years. But in our case, fistula formation occurred long after peak corticosteroid action, in the absence of conventional aetiologies.

  • Gastrointestinal system
  • Urinary tract infections
  • Renal transplantation
  • Gastrointestinal surgery
  • Urology

https://doi.org/10.1136/bcr-2022-254534

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content—SN, RG, SB and SP. The following authors gave final approval of the manuscript—SN, RG, SB and SP.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.