A Case of Enterovesical Fistula due to Ileal Diverticulitis Treated by Reduced Port Surgery

Abstract

An-83-year-old man was admitted to our hospital complaining of fatigue and painful urination. A mild elevation of the inflammatory response and urine turbidity were found. Contrast-enhanced CT and MRI showed wall thickening and an increased fat concentration in the terminal ileum and fistula between ileum and bladder. He was diagnosed with enterovesical fistula. We first carried out conservative therapy. However, since it proved to be unsuccessful, we thereafter performed reduced port surgery. A section of the small intestine around the fistula was removed and a fistula in the patient's bladder was closed with sutures under laparoscopic surgery. The patient's postoperative course was good. The pathological findings showed multiple ileal diverticula and inflammation around the perforated diverticula. Enterovesical fistula caused by ileal diverticulitis is a very rare occurrence. Laparoscopic surgery is therefore considered to be valuable as a less invasive treatment for enterovesical fistula with localized inflammation.