Enterovesical Fistulae: Aetiology, Imaging, and Management
Table 1
Advantages and disadvantages of diagnostic tests and procedures used for the detection of enterovesical fistulae.
Modality
Advantages
Disadvantages
Cystoscopy
Direct visualisation of the bladder Allows for the biopsy of a lesion
Invasive test Visualises only intraluminal content Success rate of 35%–46%
Colonoscopy
Helps to identify bowel pathology that caused a colovesical fistula
Invasive test Visualises only intraluminal content Success rate of 8.5%–55%
Poppy seed test
Noninvasive Inexpensive Convenient to perform Accuracy of up to 100%
Does not provide information on fistula location and type
Transabdominal ultrasonography
No X-ray exposure Inexpensive and available Success rate of up to 100%
Does not provide more detailed information regarding complexity of a fistula
Abdominopelvic CT
Modality of choice Diagnostic accuracy between 30 and 100% Provides information about the complexity of a fistula and the surrounding anatomical structures
X-ray exposure Expensive Often fails to identify fistulous tract
MRI
No X-ray exposure Helpful in complex cases Success rate of up to 100%
Expensive Limited availability
Barium enema
Useful in differentiating diverticular disease from colonic cancer Low perforation rates (<1%)
X-ray exposure Barium peritonitis Visualises only intraluminal content Detection rate of approximately 30%
Bourne test
Inexpensive Detection rate for colovesical fistulae of up to 90%
Does not provide information on fistula location and type
Cystogram
Easy to perform Available
X-ray exposure Low detection rate Does not provide information on fistula location Not helpful in case of a complex fistula