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Two cases of cystitis secondary to diverticulitis of the sigmoid colon are reported. One is a case of sigmoidovesical fistulas with chief complaints of pneumaturia and fecaluria. This fistula was diagnosed by barium enema examination and cystogram. In both patients, primary resection of the sigmoid colon and wedge resection of the bladder including fistula were performed. The case with sigmoidovesical fistula was completely cured, but the other case was complicated with leakage and thereafter gastrointestinal bleeding, and died at the 44th day after operation.<BR>In Japan, only 18 cases of sigmoidivesical fistula secondary to diverticulitis of the colon have been reported. The chief symptoms are pneumaturia, fecaluria and dysuria referable to the urinary tract. Barium enema examination and cystoscopy are reliable diagnostic tests. Recently, one-stage resection of the sigmoid colon including the fistula are often performed. But, if there exists a concomitant intraabdominal problem such as abscess or obstruction, postoperative major complications may occur. Therefore, preoperative colonic preparation including antiinflammatory therapy is very important.
日本大腸肛門病学会の論文