Abstract
A 40-year-old man was admitted to our hospital suffering from postprandial severe epigastralgia. Abdominal magnetic resonance imaging (MRI) and computed tomography (CT) showed cholecystolithiasis and an abscess on the right side of the bladder, and cystoscopy revealed that the abscess penetrated into the bladder. We only performed laparoscopic cholecystectomy in accordance with patient's wish to reduce the severe colicky pain. Operative findings and urinary cytology suggested that the enterovesical fistula originated from the inflammation, so we performed laparoscopic surgery. The fistula of the enteric site was at the terminal ileum, so we performed an ileocecal resection. Meanwhile, the fistula of the vesical site was sutured only. Resected specimen showed a non-specific ulcer 1 cm in diameter at the opposite site of the mesenteric attachment. Histopathological findings showed neither vasculitis nor thrombus, therefore it was hard to consider the perforating ulcer as the cause of the ischemic insult. We diagnosed the ileovesical fistula due to a simple ulcer, because the clinical symptoms did not satisfy the diagnostic criteria for Behçet's disease. Enterovesical fistula due to simple ulcer is a rare entity, we report our case with a review of the literature.
