Sigmoid diverticulitis. with colovesical fistula with neoplastic transformation

Multiple sigmoid colon diverticuli with marked circumferential long segment mural thickening of distal descending colon, sigmoid , rectosigmoid colon demonstrating paracolic mesenteric fat stranding – represents sigmoid diverticulitis.

Abnormal communication between the left lateral wall of urinary bladder and medial wall of sigmoid colon– suggestive of colovesical fistula

3.0×2.5 cm heterogeneously enhancing polypoid mass lesion is noted protruding into the bladder lumen from the left lateral wall at the point of vesical opening of fistula – of concern for neoplastic etiology

Small intravesical fecal debris with tiny air loculi at anterior aspect.

No evidence of significant lymphadenopathy.

Recommend follow up.