Pneumaturia, an unusual symptom: a case report
DOI:
https://doi.org/10.32385/rpmgf.v39i2.13521Keywords:
Pneumaturia, Urination disorder, Intestinal fistula, Case reportAbstract
Introduction: Pneumaturia consists of the elimination of air in the urine stream. It is nearly a pathognomonic symptom of a colovesical fistula. However, other differential diagnoses should be considered such as emphysematous cystitis, vesicovaginal fistula, iatrogenic injuries due to urinary catheterisation, or endoscopic or surgical procedures that were made recently.
Case description: The authors describe a case of a 55-year-old man, with previous diverticular colon disease and repetitive urinary tract infections, who has said that “I have the feeling of air elimination at the end of urinating”. Suspecting pneumaturia, an abdominopelvic TC and a colonoscopy were prescribed which have shown a colovesical fistula as a complication of sigmoid diverticular disease. The patient has undergone laparoscopic anterior resection of the rectum, without complications and with a good recovery.
Comments: In daily practice, pneumaturia is an unusual symptom and is rarely mentioned in literature. Sometimes it is the first symptom of colovesical fistula, and one should always be suspicious of this rare complication, mainly in patients with previous diverticular disease and repetitive urinary tract infections.
Downloads
References
Seeras K, Qasawa RN, Akbar H, Lopez PP. Colovesicular fistula [Internet]. Treasure Island: StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518990/
Strickland M, Burnstein M, Cohen Z. Colovesical fistulas. In: UpToDate [Internet]; 2023 Feb [updated 2023 Mar 8]. Available from: https://www.uptodate.com/contents/colovesical-fistulas
Pires CQ, Garcia J, Silva M, Clemêncio T, Amaral T. Dra., sinto gás na urina: um caso raro de pneumatúria. In: 22º Congresso Nacional de Medicina Geral e Familiar/ 17º Encontro Nacional de Internos e Jovens Médicos de Família, Caldas da Rainha, Portugal, 27-30 setembro 2018. Poster 366. Rev Port Med Geral Fam. 2019;35(Supl 2):S120.
Melchior S, Cudovic D, Jones J, Thomas C, Gillitzer R, Thüroff J. Diagnosis and surgical management of colovesical fístulas due to sigmoid diverticulitis. J Urol. 2009;182(3):978-82.
Golabek T, Szymanska A, Szopinski T, Bukowczan J, Furmanek M, Powroznik J, et al. Enterovesical fístulae: aetiology, imaging, and management. Gastroenterol Res Pract. 2013;2013:617967.
Cohan J, Varma MG. Large intestine. In: Doherty GM, editor. Current diagnosis and treatment surgery. 14th ed. McGraw Hill; 2015. p. 686-739. ISBN 9780071792110
National Institute for Health and Care Excellence. Diverticular disease: diagnosis and management – NICE guideline [NG147] [homepage]. NICE; 2019 Nov [cited 2022 Aug 14]. Available from: https://www.nice.org.uk/guidance/ng147
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Portuguese Journal of Family Medicine and General Practice
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The authors will assign to the RPMGF the sole right to publish and distribute the content of the manuscript specified in this declaration via physical, electronic, broadcasting or any other medium that may come into existence. They also grant the RPMGF the right to use and exploit this manuscript, in particular by assigning, selling or licensing its content. This permission is permanent and takes effect from the moment the manuscript is submitted, has the maximum duration allowed by applicable Portuguese or international law and is of worldwide scope. The authors further declare that this assignment is made free of charge. If the RPMGF informs the authors that it is not going to publish their manuscript, the exclusive assignment of rights ceases forthwith.
The authors authorise the RPMGF (or any entity it may appoint) to act on their behalf when it believes that copyright may have been infringed.
