Yonsei Med J.  2010 May;51(3):463-465. 10.3349/ymj.2010.51.3.463.

Laparoscopic Treatment of Appendicovesical Fistula

• Chung CW
• Kim KA
• Chung JS
• Park DS
• Hong JY
• Hong YK

• KMID: 1075004
• DOI: http://doi.org/10.3349/ymj.2010.51.3.463

Abstract

A 23-year-old man had a history of intermittent episodes of urinary tract infection with associated low abdominal pain for 15 years. Persistent bacteriuria even with prolonged antibiotics was the reason why he was referred to our hospital. Laboratory tests were normal except pyuria and growth of Escherichia coli in the urinary samples. Cystoscopy revealed a small slit-like opening on the right lateral wall of bladder dome. We found some air within the bladder and a suspicious communicating tract between the appendix and bladder on a CT scan. With a strong impression of appendicovesical fistula, a laparoscopy was performed to confirm a diagnosis and to remove the appendicovesical fistula resulting in a satisfactory result without any complication.

Keyword

Urinary tract infections; appendix; urinary bladder; fistula; laparoscopy

MeSH Terms

Adult
Appendix/*surgery
Humans
Laparoscopy/*methods
Male
Urinary Bladder/surgery
Urinary Bladder Fistula/*surgery
Urinary Tract Infections/etiology/surgery
Young Adult

Figure

• 

  Fig. 1 Cystoscopic finding shows a slit-like opening (arrowhead) on the right side of the bladder dome with a fecalith (arrow).

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  Fig. 2 Protrusion of right side of the bladder dome on voiding cystourethrography.

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  Fig. 3 Laparoscopic finding shows a grasped appendix, of which the tip is firmly attached to the right side of the bladder dome (arrow). UB, urinary bladder; C, cecum.

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