PMC10016092_01
Imaging examinations. (A): Ultrasound examination. The right bladder wall was thickened, and a 3.6 cm x 1.5 cm lesion was revealed; (B): Abdominopelvic computed tomography (CT). Focal thickening of the bladder wall and gas in the bladder were noted; (C): Computed tomography urography (CTU). Gas between the bladder dome and adjacent sigmoid colon, and a thickened bladder and sigmoid colon wall were revealed.
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Ultrasound examination showed that the right bladder wall was thickened and revealed a 3.6 cm x 1.5 cm lesion, which was considered likely inflammatory tissue ( Figure 1A ). Abdominopelvic computed tomography (CT) revealed focal thickening of the bladder wall and gas in the bladder ( Figure 1B ). These findings were consistent with a sigmoido-vesical fistula ( Figure 1C ).
(A): Cystoscopic examination. Changes in the mucosa of the bladder were noted; (B): Colonoscopy. Sigmoid colon cancer was revealed which occupied nearly the entire colon.
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The urologic surgeon performed a cystoscopic examination, which showed turbid urine and a rough bladder wall ( Figure 2A ), but no fistula was found. Colonoscopy was then performed, which revealed sigmoid colon cancer that occupied nearly the entire colon ( Figure 2B ).
Postoperative pathological outcomes. Highly differentiated tubular adenocarcinoma. (A) x40; (B) x100; (C) x200.
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A postoperative pathological examination ( Figure 3 ) confirmed persistent, highly differentiated tubular adenocarcinoma (about 7.0 x 4.0 x 4.5 cm in size) accumulating almost the entire colonic wall.
Case timeline.
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