A fistula may develop between the ureter and various parts of the gastrointestinal tract. The subsequent findings depend on a number of factors such as the location, size, cause, and the hydration status of the patient.


Types of uretero-enteric fistulas:

(1) with the colon (uretero-colic) - most common form

(2) with the duodenum (uretero-duodenal)

(3) with the jejunum (uretero-jejunal)

(4) with the ileum (uretero-ileac)


Predisposing factors:

(1) trauma

(2) cancer

(3) iatrogenic injury

(4) severe urinary tract infection, including tuberculosis and urinary calculi

(5) ulcer disease (duodenal ulcer, Crohn's disease)

(6) radiation therapy

(7) diverticulitis


Clinical findings may include:

(1) hematuria

(2) pneumaturia

(3) fecaluria

(4) diarrhea

(5) flank pain

(6) recurrent urinary tract infections


The diagnosis can be made with imaging studies using contrast material or with chemical dye (with urinary dye appearing in the colon or enteric dye appearing in the urine).


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