Abstract
INTRODUCTION: Colovesical fistula is the pathological communication between the colon and urinary bladder. It is related with high morbimortality rate and it is and uncommon complication of diverticulosis in young adults. CASE PRESENTATION: We report a case of a 38-year-old Brazilian man with fecaluria and pneumaturia for eight months, whose colovesical fistula was undetectable in CT scan and with surgical management. DISCUSSION: Diverticulosis is the main inflammatory condition causing colovesical fistulas and the sigmoid colon is the most common part involved. It is more prevalent in patients over 60 years old and in western countries due to low fiber diet. CONCLUSION: Colovesical fistula diagnosis is difficult, requiring high suspicious and proper investigation through good anamnesis, CT scan and also colonoscopy and cystoscopy when necessary.