Findings-The sigmoid shows diverticula and is attached to the dome of the bladder.
-A fistulous tract is seen filled with air and contrast between the sigmoid and the bladder.
-There is air and colonic contrast within the bladder lumen.
Discussion
A fistula between the bladder and colon may occur due to a number of diseases, most notably colon cancer, bladder cancer, Crohn’s disease, and diverticulitis. CT stages diverticulitis from Stage 0 through Stage IV depending on surrounding involvement and severity. Stage 0 shows only minor local colonic wall involvement and may be treated conservatively with antibiotics. The other stages usually necessitate surgical intervention. Stages I and II show contiguous spread of inflammation outside of the colon. Stages III and IV show peritoneal involvement with distant abscesses, ascites, through to frank peritonitis.
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