CASE REPORTS

Post-operative vesicoenterocutaneous fistula with multiple intestinal knotting: A case report

Abdullahi Khalid, Ahmed Mohammed Umar, Abdullah Abdulwahab-Ahmed, Abubakar Sadiq Muhammad, Ngwobia Peter Agwu, Ismaila A Mungadi

Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Correspondence Address:
Dr. Abdullahi Khalid
Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria

Source of Support: None
Conflict of Interest: None

Herein is a case of a 51-year-old farmer who presented to our facility with initial leakage of urine but later urine mixed with faeces from the lower abdomen after two previous abdominal surgeries. He had an open transvesical prostatectomy due to benign prostate enlargement complicated by leakage of urine from lower abdominal wall scar. A repeat surgical intervention to correct the urine leakage was followed by recurrence of urine leakage and later by leakage of feculent urine from the lower anterior abdominal wall. At our facility, he had exploratory laparotomy with manual unknotting of ileal loops, fistula tracts excision, resection, and end-to-end ileoileal anastomosis. The bladder wall was repaired with suprapubic cystostomy. Although the finding of asymptomatic multiple small bowel knotting was incidental in the index case, its timely management averted a sitting timed bomb that may lead to a diagnostic dilemma with catastrophic consequences.