Laparoscopic management of post-traumatic fistula: brief review of the literature on the subject of a case
DOI:
https://doi.org/10.48193/t589x719Keywords:
Fístula, vesico-rectal, enterovesical, laparoscópico, arma de fuego, traumaAbstract
Case description: a 41-year-old male patient was admitted to the emergency department for penetrating pelvic trauma due to a firearm projectile. He required exploratory laparotomy in which a bladder and rectal injury was found, both grade V, performing initially repair with primary closure of the bladder and rectum. In the post-surgical follow-up, an abnormal communication was found between the bladder, rectum and soft tissues of the gluteal region. He was protocolized for laparoscopic repair of vesico-rectal fistula.
Relevance: in Mexico, gunshot wounds represent the most common cause of penetrating abdominal trauma. Injuries to the involved organs retain a high risk of developing subsequent fistulas.
Clinical implications: to our knowledge, this review represents the first report of minimally invasive management of bladder-rectal fistula of post-traumatic origin.
Conclusions: penetrating trauma is an increasingly frequent cause of urinary tract injury, and the development of complications implies a considerable impact on patients' quality of life. The management of urinary fistulas secondary to trauma is not well standardized. This report demonstrates the feasibility of laparoscopic approach for the resolution of vesicorectal fistulas.
References
De Ridder D, Greenwell T. Urinary Tract Fistulae. In: Campbell Walsh Wein Urology. Elsevier; 2021. p. 2924–2963.
Golabek T, Szymanska A, Szopinski T, Bukowczan J, Furmanek M, Powroznik J, et al. Enterovesical fistulae: aetiology, imaging, and management. Gastroenterology Research and Practice. 2013;2013: 617967. https://doi.org/10.1155/2013/617967.
Granieri S, Sessa F, Bonomi A, Paleino S, Bruno F, Chierici A, et al. Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence. BMC surgery. 2021;21(1): 265. https://doi.org/10.1186/s12893-021-01272-6.
Cochetti G, Del Zingaro M, Boni A, Cocca D, Panciarola M, Tiezzi A, et al. Colovesical fistula: review on conservative management, surgical techniques and minimally invasive approaches. Il Giornale Di Chirurgia. 2018;39(4): 195–207.
Chiang SF, Hung HY, Changchien CR, Chen JS, Tang R. Is surgical intervention always needed for traumatic rectovesical fistula?—We demonstrate an experience of nonsurgical management of traumatic rectovesical fistula. Injury Extra. 2009;40(2): 29–31. https://doi.org/10.1016/j.injury.2008.10.025.
Crispen PL, Kansas BT, Pieri PG, Fisher C, Gaughan JP, Pathak AS, et al. Immediate postoperative complications of combined penetrating rectal and bladder injuries. The Journal of Trauma. 2007;62(2): 325–329. https://doi.org/10.1097/01.ta.0000231767.20289.bc.
Hornez E, Monchal T, Boddaert G, Chiron P, Danis J, Baudoin Y, et al. Penetrating pelvic trauma: Initial assessment and surgical management in emergency. Journal of Visceral Surgery. 2016;153(4 Suppl): 79–90. https://doi.org/10.1016/j.jviscsurg.2016.04.006.
Gomez RG, Ceballos L, Coburn M, Corriere JN, Dixon CM, Lobel B, et al. Consensus statement on bladder injuries. BJU international. 2004;94(1): 27–32. https://doi.org/10.1111/j.1464-410X.2004.04896.x.
Kolukcu E, Beyhan M, Alatli T, Ozbek LM, Yildiz MI. Isolated Bladder Perforation in Gunshot Wound: A Case Report. Eurasian journal of medicine and oncology. 2019;3(4): 336–339.
Holroyd DJ, Banerjee S, Beavan M, Prentice R, Vijay V, Warren SJ. Colovaginal and colovesical fistulae: the diagnostic paradigm. Techniques in Coloproctology. 2012;16(2): 119–126. https://doi.org/10.1007/s10151-012-0807-8.
Zizzo M, Tumiati D, Bassi MC, Zanelli M, Sanguedolce F, Porpiglia F, et al. Management of colovesical fistula: a systematic review. Minerva Urology and Nephrology. 2022;74(4): 400–408. https://doi.org/10.23736/S2724-6051.21.04750-9.
Froiio C, Bernardi D, Asti E, Bonavina G, Conti A, Carmignani L, et al. Burden of Colovesical Fistula and Changing Treatment Pathways: A Systematic Literature Review. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2022;32(5): 577–585. https://doi.org/10.1097/SLE.0000000000001099.
Pinedo-Onofre JA, Guevara-Torres L, Sánchez-Aguilar JM. Trauma abdominal penetrante. Cir. & cir. 2006; 431–442.
Cantú-Alejo DR, Reyna-Sepúlveda F, García-Hernández S, Sinsel-Ayala J, Hernández-Guedea M, Rodríguez EP, et al. Presentation, management and evolution of patients with abdominal gunshot wound. A decade of violence in Mexico. Cirugia Y Cirujanos. 2021;89(1): 39–45. https://doi.org/10.24875/CIRU.19001710.
Parra-Romero G, Contreras-Cantero G, Orozco-Guibaldo D, Domínguez-Estrada A, Campo J de JMMD, Bravo-Cuéllar L. Abdominal trauma: experience of 4961 cases in Western Mexico. Cirugia Y Cirujanos. 2019;87(2): 183–189. https://doi.org/10.24875/CIRU.18000509.
Pereira BM, Reis LO, Calderan TR, de Campos CC, Fraga GP. Penetrating bladder trauma: a high risk factor for associated rectal injury. Advances in Urology. 2014;2014: 386280. https://doi.org/10.1155/2014/386280.
Franko ER, Ivatury RR, Schwalb DM. Combined penetrating rectal and genitourinary injuries: a challenge in management. The Journal of Trauma. 1993;34(3): 347–353.
Zapata-González JA, Corona-Montes V, Ramírez-Pérez EA, López-Alvarado D. Tratamiento laparoscópico de las fístulas colovesicales: experiencia preliminar. Revista Mexicana de Urología. 2015;75(6). https://doi.org/10.48193/revistamexicanadeurologa.v75i6.286.
Campobasso D, Zizzo M, Biolchini F, Castro-Ruiz C, Frattini A, Giunta A. Laparoscopic management of colovesical fistula in different clinical scenarios. Journal of Minimal Access Surgery. 2024;20(2): 175–179. https://doi.org/10.4103/jmas.jmas_245_22.
Gilshtein H, Yellinek S, Maenza J, Wexner SD. Surgical management of colovesical fistulas. Techniques in Coloproctology. 2020;24(8): 851–854. https://doi.org/10.1007/s10151-020-02247-0.
Zapata-González JA, Camacho-Castro JB, Reyna-Bulnes AI, García-Sánchez SM, Reyes-Verástegui F, Niño-Ortiz LE, et al. Tratamiento laparoscópico de una fístula vesicovaginal compleja. Revista Mexicana de Urología. 2014;74(1): 44–47. https://doi.org/10.1016/S2007-4085(15)30009-4.
Mahdavi A, Nezhat F, Berker B, Nezhat C, Nezhat C. Laparoscopic management of vesicovaginal fistula. In: Textbook of Laparoscopic Urology. CRC Press; 2006.
Dolejs SC, Penning AJ, Guzman MJ, Fajardo AD, Holcomb BK, Robb BW, et al. Perioperative Management of Patients with Colovesical Fistula. Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract. 2019;23(9): 1867–1873. https://doi.org/10.1007/s11605-018-4034-0.
Garza Cortés R, Clavijo R, Sotelo R. Tratamiento laparoscópico de fístulas genitourinarias. Archivos Españoles de Urología. 2012; 659–672.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Revista Mexicana de Urología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
