Urograms of interest to our readers are welcome from tributions, including an abbreviated history and legendfor thefilms, M.D., feature editor.
urologists and radiologists. Conare to be sent to Arthur N. Tessler,
FIGURE 1. Intravenous pyelogram demonstrating vesical diverticulum in trabeculated bladder and normal-appeakg upper tracts.
762
UROLOGY
/ DECEMBER1975
/ VOLUMEVI,
NUMBER6
I
1
1 PROFILE
1
A seventy-six-year-old black male was admitted to the hospital with uriuary reteution aud sepsis. After supportative therapy, an intravenous urogram demonstrated essentially normal upper urinary tracts and several vesical diverticula (Fig. 1). Cystogram performed under fluoroscopic control demonstrated a communication between the bladder, a superiorly located abscess cavity, and the jejunum (Fig. 2). Surgical exploration revealed carcinoma of the bladder arising in a diverticulum. It eroded through the lining of the diverticulum, forming a fistula with the mid-jejunum. Pathologic examination revealed this to be transitional cell carcinoma, grade IV. Partial cystectomy combined with small-bowel resection and enteroenterostomy were performed. This case illustrates one of the less common etiologies and locations of vesicoenteric fistula.
FIGURE 2.
tion between
UROLOCY
Cystogram demonstrating a communicabladder and jejunum (arrow).
/ IIECEklBEB
1975 / VOLC’klE VI, NUMBER 6
Anthony J. Perri, .CI.D. Arthur E. Feldman, M.D. A. Richard Kendall, M.D. Lester Karafin, M.D. Temple University Medical School 3300 Henry Avenue Philadelphia, Pennsylvania 19129