Laparoscopic Repair for Vesicoperitoneal Fistula with Vesicouterine Abscess

Doppler ultrasound contribution in vesico-peritoneal and vesico-cutaneous fistulas diagnosis: two case reports of a new sign

Background

Report cases of vesico-peritoneal and vesico-cutaneous fistulas suspected to Doppler ultrasound confirmed by CT scan/conventional cystography and successfully treated.

Case presentation

Two male patients of 35- and 36-year-old, without any medical past history, had presented anuria and absence of miction respectively after a road traffic accident and a piece of wood penetrating the left thigh. The physical examination revealed lower limbs hematoma and severe abdominal pain in the man of 35 years and a sutured wound of the left thigh of 4 cm with a bright liquid flowing from it with the characteristic smell of urine in the man of 36 years. A Doppler ultrasound was made. The Doppler had shown normal ureteral jets but with a third abnormal flux which went from interior to exterior of the urinary bladder for the first patient and from the bladder to the left inguinal cutaneous tissue for the second patient. The treatment was a Foley’s catheter into the bladder with antibiotics in the two cases after excision and separate suture of the peritoneum and bladder during umbilical laparotomy in the first case. The suites were simples.

Conclusions

The diagnostic contribution of CT/conventional cystography is well known and undisputed, but for Doppler ultrasound, it is anecdotal like in these cases we report. Nevertheless, there is a need to evaluate the semiological value of Doppler ultrasound contribution on a greater sample.