Case Report Concealed Enterovesical Fistula Associated with Forgotten Intra-Abdominal Haemostat and Intravesical Towel Ademola Alabi Popoola, 1 J. O. Bello, 1 G. G. Ezeoke, 2 K. T. Adeshina, 2 and A. Fadimu 1 1 Urology Unit, Department of Surgery, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria 2 Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, University of Ilorin, P.O. Box 4718, Ilorin 24001, Kwara State, Nigeria Correspondence should be addressed to Ademola Alabi Popoola; ademola67@yahoo.com Received 27 January 2014; Accepted 29 March 2014; Published 14 April 2014 Academic Editor: Apul Goel Copyright © 2014 Ademola Alabi Popoola et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Enterovesical fstula is rare and is ofen caused by bowel infammatory diseases and tumours in the urinary bladder or the intestine with local infltration of bowel or bladder, respectively. Te fstula usually presents with lower urinary tract symptoms, pneumaturia, and faecaluria or with food particles in the urine. Intra-abdominal retained surgical foreign bodies have also been reported as causes. Case Presentation. A case of atypical presentation in a woman with enterovesical fstula following abdominal hysterectomy. Investigations confrmed the presence of surgical towel in the urinary bladder and a pair of artery forceps in the abdomen. Te towel was removed at cystoscopy afer which she presented with food particles in the urine. She later had laparatomy to remove the haemostat and to repair the fstula. Discussion. A typical presentation of enterovesical fstula delayed the diagnosis and treatment in this patient. Conclusion. Managing patients with recurrent urinary tract infection afer abdominal operation should include appropriate imaging of the abdomen with emphasis on pelvic organs. Also, surgical operation should always be given the best shot the frst time and strict operation room standards and guidelines should always be followed. 1. Introduction Enterovesical fstula (EVF) is an abnormal communication between the intestine and the urinary bladder. It is rare and studies have reported an incidence of less than 4 cases per year [1, 2]. Enterovesical fstulae ofen result from local infl- tration of the urinary bladder by intestinal tumours resulting in a communication between these two luminal organs [3]. However, there have been reports of reversed scenarios whereby the fstula followed invasion of contiguous loops of bowel by squamous cell carcinoma of the urinary bladder [4]. Apart from tumours, bowel infammatory diseases such as Crohn’s disease also rank high in the etiology of EVF [5]. Urethral catheterization of compromised urinary bladders afer external beam radiotherapy for pelvic tumours has also been implicated in the aetiology [6]. Spontaneous occurrence of EVF attributable to no specifc cause has also been reported [7]. EVF usually presents with symptoms such as the presence of food particles in the urine, lower urinary tract symptoms, pneumaturia, and faecaluria. Alapont P´ erez et al. reported that 78% of their patients presented with pneumaturia and faecaluria [8]; it is therefore uncommon for EVF to remain occult betraying with no classical symptoms or signs. Retained surgical foreign bodies (RSFB) following oper- ative procedures have been reported [9–11]. Te exact inci- dence rate may be difcult to ascertain for reasons which may include but are not limited to the fear of litigation [12]. Tere are various complications associated with RSFB which range from abdominal pains [10] to death [9]. Gossypiboma (retained gauze) usually presents with symptoms such as abdominal pain, swelling, or signs of occult infections [13]. Intra-abdominal foreign bodies have been associated with erosion into luminal or hollow structures creating diferent forms of internal and external fstulae with var- ious presentations depending on the structures involved. Tere have been reports of aortoenteric fstulae from RSFB manifesting as gastrointestinal hemorrhages [14]. Entero- or colocutaneous fstulae have also resulted from RSFB [15]. Hindawi Publishing Corporation Case Reports in Urology Volume 2014, Article ID 723592, 4 pages http://dx.doi.org/10.1155/2014/723592