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