Vesicoappendiceal fistula detected during the treatment of renal pelvic calculus: A case report

A 58-year-old man, after receiving treatment for acute pyelonephritis caused by impaction of right ureteral stone, was refferd to our department for further treatment of the stone in January 2008. However, fecaluria was found which caused him to be hospitalized for close investigation. For the past 11 years, the patient has had a history of repeating cystitis with pneumaturia. In cystoscopic examination, outflow of fecaluria from the fistulae of the top of the right-sided bladder was found. In bladder contrast study, outflow of contrast agent into ascending colon was demonstrated. Under the diagnosis of vesicointestinal fistula, we performed laparoscopic assisted small incision surgery. Diagnosis of vesicoappendiceal fistula caused by appendiceal diverticulum was made by histological observation. This case seems to be the 51st case of vesicoappendiceal fistula in Japan.