Enterovesical fistula secondary to migrated transpapillary stent

The patient is an 83-year-old woman with a history of endometrial cancer treated with hysterectomy, double adnexectomy and brachytherapy; radiation cystitis and enteritis; incisional hernia repair; cholecystectomy and plastic biliary stent placement for choledocholithiasis (2009) (not withdrawn due to incomplete follow-up); and recurrent urinary tract infections. Presently, she consulted for fecaluria and abdominal pain. Radiography showed an elongated radiopaque image and a rounded radiopaque image in the pelvis. Computed tomography detected cystolithiasis and a tubular structure connecting the ileum and the bladder. After administration of intravesical contrast and filling of the ileum, an enterovesical fistula was demonstrated due to stent migration. We performed intestinal resection and partial cystectomy without incident (Figs. 1 and 2).

Fig. 1

Fig. 2