临床误诊误治2025，Vol.38Issue(9)：21-27,7.DOI:10.3969/j.issn.1002-3429.2025.09.004
膀胱乙状结肠瘘误诊原因分析及防范措施
Analysis of Causes of Misdiagnosis of Vesicosigmoid Fistula and Preventive Measures
摘要
Abstract
Objective To analyze the clinical characteristics,diagnosis,differential diagnosis,causes of misdiagno-sis and preventive measures of vesicosigmoid fistula.Methods From March 2022 to April 2023,the clinical data of 2 pa-tients with vesicosigmoid fistula misdiagnosed as bladder cancer were retrospectively analyzed.Results Two patients were ad-mitted due to rectal mass for 3 d and intermittent gross hematuria for 9 d,respectively.Both patients were misdiagnosed as bladder cancer and underwent transurethral resection of the bladder.The postoperative pathology showed bladder granuloma-tous inflammation and cystitis glandularis.The diagnosis of vesicosigmoid fistula was confirmed following the location of the fis-tula identified by CT plain scan after retrograde injection of contrast agent into the bladder through a urinary catheter.The mis-diagnosis lasted 1 to 2 weeks.One patient underwent open partial resection of sigmoid colon and vesicosigmoid fistula repair.One patient underwent laparoscopic partial resection of sigmoid colon+vesicocolonic fistula repair+partial cystectomy.All patients recovered well after operation and no abnormality was found during follow-up.Conclusion Vesicosigmoid fistula is rare in clinical practice.Several patients are more likely to experience missed diagnosis and misdiagnosis due to lack of specif-ic symptoms,insufficient understanding of clinicians,and limited imaging examination.Clinicians should be highly alert to vesicosigmoid fistula to avoid delay in treatment.关键词
膀胱乙状结肠瘘/误诊/膀胱癌/膀胱肉芽肿性炎/腺性膀胱炎/乙状结肠憩室/膀胱乙状结肠瘘修补术Key words
Vesicosigmoid fistula/Misdiagnosis/Bladder cancer/Bladder granulomatous inflammation/Cystitis glandularis/Sigmoid diverticulum/Vesicosigmoid fistula repair分类
临床医学引用本文复制引用
刘伟,周正兴,李清华,许国胜,孙松,陈红兵..膀胱乙状结肠瘘误诊原因分析及防范措施[J].临床误诊误治,2025,38(9):21-27,7.基金项目
合肥市卫生健康委员会项目(Hwk2024zd010) （Hwk2024zd010）
