Entero-Vesical Fistulae

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The term entero-vesical fistula includes all those cases in which a communication, direct or indirect, exists between the bladder and any portion of the intestinal tract, from the pyloric orifice to the anus. The condition is somewhat rare, as evidenced by a review of the literature. The first attempt to collect and classify these cases was made by Blanquinque in 1870. The older writers considered the condition beyond the reach of “the art,” and the first suggestion as to rational treatment was made by Barbier de Melle in 1843. He believed the site of the fistula was always in the cecum and proposed colostomy as a means of cure. Pennell, in 1850, and Curling, in 1852, first used this procedure. However, up to 1870, only six colostomies had been performed for entero-vesical fistula.

In 1870 Simon operated on. two patients with recto-vesical fistula, sectioning the rectal sphincter and making a direct suture of the rectal orifice of the fistula. He was successful in one case. Billroth, in the same year, performed this type of operation without success. Dumeni, in 1884, reported a case of recto-vesical fistula before the French Surgical Congress at Rouen, and highly extolled colostomy as a means of relief; it is probably due largely to him that this procedure became popularized. Suprapubic cystotomy and suturing of the bladder orifice of the fistula was first suggested by Le Dentu in 1884. This method was used for a time, but without success. In 1887 Czerny performed the first laparotomy. . .



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