Colovesicle Fistulae: Causes
- Diverticulitis
- Crohns disease
- Foreign body perforation
- Radiation injury
- Surgical misadventure

Colovesicle Fistulae: Facts
- Can be reliably diagnosed with CT using rectal contrast or contrast in the bladder but not both
- Surgery is the treatment of choice to avert complications with high morbidity and mortality
- In crohns disease fistulae usually between ileum and bladder

Emphysematous cystitis
“ Emphysematous cystitis is a rare clinical entity, more commonly seen in diabetic, immunocomprimised patients. A conservative treatment approach using antibiotics and bladder catheterization is typically successful, with a complication rate of only 18.8%.”
Emphysematous Cystitis
Reese AC, Stoller ML
Urology 2010 Jun;75(6):1315-6

Bladder Trauma: Facts
- 10% of GU system injuries are to the bladder
- Bladder injures occur in 1.6% of blunt abdominal trauma cases
- Bladder rupture occurs in 2-11% of patients with pelvic fractures
- 60-90% of patients with bladder rupture have a pelvic fracture

Bladder Trauma: Etiology
- Blunt trauma (60-85%)
- Penetrating trauma (15-40%)
- Iatrogenic trauma (5%)

Bladder Trauma: 5 Categories
- Contusion
- Intraperitoneal (15-20%)
- Interstitial or bladder wall hematoma
- Extraperitoneal (70-80%)
- Combined (5-10%)
---Lower Urinary Tract Trauma
---Sandler CM et al
---World J Urol 16:69-75

Intraperitoneal Bladder Rupture: Facts
- 15-20% of cases of rupture
- Delayed diagnosis results in increased mortality due in part to risk of chemical peritonitis
- Patients require surgical management

“ MDCT cystography should be done when pelvic fluid is present, especially when there are fractures or gross hematuria, to define which of the patients has a bladder rupture and to define the type of bladder rupture.”
Bladder trauma: multidetector computed tomography cystography
Ishak C, Kanth N
Emerg Radiol (2011) 18:321-327