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May 1967

Vesicocolic Fistula—A Complication of Colonic Cancer: Long-Term Results of Its Surgical Treatment

Author Affiliations

Rochester, Minn
From the Section of Surgery, Mayo Clinic and Mayo Foundation (Dr. ReMine), and the Mayo Graduate School of Medicine (University of Minnesota) (Dr. Aldrete), Rochester.

Arch Surg. 1967;94(5):627-637. doi:10.1001/archsurg.1967.01330110043006

CARCINOMAS of the colon may invade the urinary bladder; the neoplastic invasion and the added inflammatory reaction can produce ulceration and necrosis of the colonic and vesical walls, resulting in a vesicocolic fistula of malignant origin. The surgical treatment of the patients presents a supplementary challenge, since excision of a full-thickness portion of the involved segment of the bladder will be necessary, in addition to resection of the colonic cancer.

Cancers of the colon occasionally are adherent to the urinary bladder. Lockhart-Mummery1 reported this finding in 157 (4%) of 3,780 patients who had cancer of the left portion of the colon, excluding the rectum, and were seen over 25 years (1928 through 1952) at St. Marks Hospital of London. In 23 of these patients, fistulas had developed into the lumen of the bladder, which gives an incidence of vesicocolic fistula of 0.6% in all cases of cancer of the

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