Ruminations by a non-academic general surgeon from the heart of the rust belt.
Thursday, July 8, 2010
This is about as bad as it gets. I saw an elderly lady with a chief complaint of frequent urinary infections and passage of stool per her vagina. The images above demonstrate obvious colovesical and colouterine fistulae. The CT also demonstrated significant left ureteral obstruction at the level of the pelvic inlet. What ensued was a complex multi-specialist procedure involving a sigmoid resection, hysterectomy/oophorectomy, and ureteral stenting. Good stuff.