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June 1958

Sigmoidovesical Fistula Secondary to Diverticulitis

Author Affiliations

Evanston, III.
From the Department of Surgery, Northwestern University Medical School, Chicago, and the Evanston, Hospital.; Chief Surgical Resident, Evanston Hospital; now practicing in Green Bay, Wis. (Dr. Lynn). Assistant Professor of Urology, Northwestern University Medical School (Dr. Farrell). Associate Professor of Surgery, Northwestern University Medical School (Dr. Grier).

AMA Arch Surg. 1958;76(6):956-962. doi:10.1001/archsurg.1958.01280240114018

Diverticulitis is the commonest cause of a sigmoidovesical fistula. Another inflammatory process, neoplasia, trauma, or a congenital abnormality may be responsible. A highly resistant lower urinary tract infection should suggest the possibility of an incipient or established vesico intestinal fistula. Pneumaturia and fecaluria are positive evidence of such a communication. Surgical excision of the diseased segment of colon and closure of the vesical opening is the procedure of choice. In many cases this may be carried out as a primary procedure.

General Background 

History.  —Cripps,3 in 1888, found that inflammatory lesions more frequently caused sigmoidovesical fistula than did malignant lesions. Heine,5 in 1904, and Moynihan,11 in 1907, realized the importance of diverticulitis as an etiologic factor in these fistulae. In 1917, Telling and Gruner15 made an extensive study of diverticulosis and diverticulitis and observed that in 19.8% of the cases reviewed some type of fistula was

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