Clin Orthop Surg.  2009 Sep;1(3):176-179. 10.4055/cios.2009.1.3.176.

Vesicocutaneous Fistula Presenting Groin Abscess and Chronic Osteomyelitis in Pubic Bone

• Kim SB
• Jung WK
• Song DI
• Lee SH

• KMID: 999398
• DOI: http://doi.org/10.4055/cios.2009.1.3.176

Abstract

The authors report a case of bladder fistula associated with a medial thigh cutaneous fistula and chronic osteomyelitis of the pubic bone 11 years after surgery for a pelvic bone fracture and bladder rupture. In the presenting case, despite the clinical suspicion, none of the diagnostic tools demonstrated the bladder fistula preoperatively. This case suggests that bladder repair should be prepared, even if the bladder fistula cannot be confirmed by imaging studies because the amount of urine leakage can be minimal or the fistula can close spontaneously.

Keyword

Bladder; Fistula; Chronic osteomyelitis

MeSH Terms

Abscess/complications/*diagnosis
Cutaneous Fistula/complications/*diagnosis/radiography/surgery
Groin
Humans
Male
Middle Aged
Osteomyelitis/complications/*diagnosis/radiography
Pelvis/radiography
*Pubic Bone/surgery
Urinary Bladder Fistula/complications/*diagnosis/radiography/surgery

Figure

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  Fig. 1 Clinical photograph: The left groin was swollen with erythematous change and a small fistulous opening was found at the center of the lesion.

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  Fig. 2 Initial anteroposterior radiograph of the pelvis.

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  Fig. 3 MRI shows an abscess (white arrow) within the deformed pubic ramus and the adductor longus, extending to the subcutaneous tissue, and osteomyelitis (black arrow) in the adjacent bone.

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  Fig. 4 CT cystogram shows no contrast connections from the bladder to the abscess of the pubis and thigh.

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  Fig. 5 Postoperative anteroposterior radiograph of the pelvis.

Reference

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