作者報告一位以復發性泌尿道感染及膀胱腫瘤表現之大腸膀胱瘻管病例。一位70歲女性，主訴一年多來經常因復發性泌尿道感染，而有頻尿、解尿疼痛、血尿及下腹痛等泌尿道症狀。理學檢查除左下腹輕微壓痛外無其他異常發現，病人合併有嚴重貧血。經膀胱鏡檢查，發現膀胱左側壁，有一約3公分大小之黏膜下腫瘤，經膀胱鏡切片後，並未見有惡性腫瘤之病變。後續腹部電腦斷層檢查，亦發現膀胱左側壁疑有一腫瘤，其與大腸緊密相聯，且有多個大腸憩室，疑為併發於大腸憩室炎或膀胱癌之大腸膀胱瘻管。病人拒絕進一步檢查治療，並要求繼續保守觀察，其後6個月病人仍持續地發生復發性泌尿道感染。經第二次電腦斷層檢查，發現該膀胱腫瘤有明顯變大之現象。於是再次進行膀胱鏡檢查，發現膀胱左側壁先前切片處，有一瘻管之開口並有糞便樣之液體斷續噴出，初步診斷為併發於大腸憩室炎之大腸膀胱瘻管。因為由影像學檢查仍無法排除併發有膀胱癌，或大腸癌之可能性，病患決定接受剖腹探查以確診並治療該病灶。經手術切除該段與膀胱相沾黏之乙狀結腸及膀胱左側壁，並將大腸重新接合及縫合膀胱。術後病理報告。確定該病例為併發於大腸憩室炎之大腸膀胱瘻管。病人術後無其他併發症，於6個月術後追蹤情況穩定。

The authors report a case of colovesical fistula (CVF) presented with recurrent urinary tract infection (UTI) and bladder tumor. A 70 years old female had suffered from recurrent episodes of UTI for one year. Severe anemia (hemoglobin 6.6 g/dl) was present. Initial image study suggested the presence of a large submucosal tumor over the left sided bladder wall and colon diverticulosis. Bladder biopsy was negative for malignancy. The patient refused further intervention and continued to suffer from recurrent UTI. A CT scan six months later showed the bladder mass was growing much larger. A fistula opening in bladder was detected by a second cystoscopy. Under the impression of CVF, possibly complicated by colon diverticulitis, bladder or colon cancer, the patient was subjected to primary resection of sigmoid colon and partial cystectomy. A benign CVF was confirmed. She was well at 6 months of follow-up.