Gastrointestinal pathology: Large intestine: Colo-vesical fistula

A 1953 autopsy specimen from a 56 year old man who complained of "passing wind in the urine" for two days. A year before he had had a fever and abdominal colic, associated with mucous diarrhoea. Three weeks later he noticed frequency with scalding. The urine contained a heavy deposit. On examination he was pyrexial and on rectal examination a tense, tender swelling in the pelvis was found. A transverse colostomy was performed and although the urinary infection cleared, his pyrexia remained. Ten days later he became drowsy, disorientated and later developed a left-sided hemiplegia and neck stiffness. He died three weeks after the colostomy had been fashioned.