A Case of Colonic Bladder Fistula Due to Sigmoid Colon Diverticulitis Treated Laparoscopically

Abstract

A 52-year-old man visited our hospital with lower abdominal pain, urination pain, and dysuria. Abdominal computed tomography showed many diverticula in the sigmoid colon and adherence between the sigmoid colon and bladder was confirmed. Since we found air in the bladder, our diagnosis was a colonic bladder fistula due to sigmoid colon diverticulitis. Fasting intravenous drip therapy with antibiotics was performed. After relief of the inflammation, laparoscopic surgery was performed, using magnification via the laparoscope of the layer on the colon side, and the fistula was closed with the Vessel Sealing System. The sigmoid colon was excised and anastomosis of the sigmoid colon and the rectum was performed without diversion. About 200mL of physiological saline was injected into the bladder, it was confirmed that there was no outflow from the fistula, and surgery was terminated without any additional procedure for the bladder. We placed a urethral balloon for decompression of the bladder, but it was withdrawn on the 6th postoperative day. The patient was discharged without complications on the 18th postoperative day. A colonic bladder fistula due to sigmoid colon diverticulitis was treated laparoscopically after relief of the inflammation, making it possible to treat less invasively with few complications.