Complications | Fistula at the navel

Complications

A fistula at the navel, which emerges from the bladder, may be present in newborns. During the development of the child in the womb, there is a temporary connection between the fetal bladder and the navel (Urachus). However, this normally recedes and closes.

In the case of an abnormal development, however, the passage can remain (uracic fistula), which is expressed by urine running from the child’s navel. In such a case, the fistula should be promptly removed by a minor surgical procedure, otherwise there is a risk of serious inflammation of the urinary tract and kidneys. In adults, fistulas usually enter the bladder from the intestine.

As a result, faeces and intestinal bacteria from the intestines can enter the bladder and cause inflammation. In order to prove a bladder-intestinal fistula in suspected cases, a simple diagnostic procedure can be performed: In the so-called poppy seed swallow test, the patient consumes about 100 grams of poppy seed. The urine is then collected and sieved.

If poppy seeds are found there, a connection between the intestine and the bladder has been proven. A fistula at the navel does not usually originate from the vagina. However, a fistula originating from the intestine can grow into the vagina.

This is usually expressed by the fact that faeces, which enter the vagina from the intestine via the fistula, exit the vagina. In addition, the intestinal bacteria can cause an inflammation of the fistula or the vagina, which is manifested by a purulent, malodorous discharge. In case of corresponding complaints, the gynecologist should be consulted promptly. Through the vaginal examination, the doctor can in some cases see the fistula outlet. He can also issue a hospitalization certificate, so that the fistula can be visualized by means of imaging techniques and, if necessary, treatment can be administered.

Therapy

To treat a fistula at the navel, surgery is required in most cases. There is no alternative promising form of therapy.The aim of the treatment is the complete removal of the fistula tract and the closure of the unnatural connection. Various surgical procedures are available, the choice of which depends on the cause and the organs involved. Often, a single operation is not sufficient to treat the fistula, because the fistula tract could not be completely removed or because fistulas reappear. Therefore, follow-up is an important part of the therapy of a fistula at the navel.