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Case History: 50-year-old patient with ovarian cancer and total abdominal hysterectomy presented with urinary incontinence.
Case History: 50-year-old patient with ovarian cancer and total abdominal hysterectomy presented with urinary incontinence.
50-year-old patient with ovarian cancer and total abdominal hysterectomy presented with urinary incontinence.
In most instances, the diagnosis is suspected clinically due to pneumaturia, fecaluria, recurrent urinary tract infections, or passage of urine rectally.
On CT, the fistula will be heralded by the presence of gas within the lumen of the bladder or, less frequently, direct demonstration of the tract itself.
When the communication is between the rectum and urinary bladder, the term rectovesical fistula is used.
Surgical resection of the fistula and abnormal segment of bowel is usually required for cure, although in the setting of malignancy, this suggests advanced disease (T4) making surgery complex.
The fistula may be seen as a hypodense area with excretion of contrast into the vagina on a delayed CECT film.