This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Anatomy
True about Colovesical fistula? 
Select and explain. 
A. Most commonly presents with pneumaturia, B. More common in females, C. Most commonly caused by colon cancer, D. Readily diagnosed on barium enema
A: Most commonly presents with pneumaturia
Answer: A: Most commonly presents with pneumaturia 
Explanation: Colovesical fistulaA colovesical fistula is the presence of a communication between the lumen of the colon and that of the bladder, either directly or an intervening abscess cavityCausesDiveiculitis: most common ~ 60%Colorectal cancer (CRC) : ~ 20%Crohn&;s disease: ~ 10%RadiotherapyAppendicitisTraumaClinical presentationRadiographic featuresIn most instances, the diagnosis is suspected clinically due to pneumaturia, faecaluria, recurrent urinary tract infections, or passage of urine rectally.In some cases, it will be first diagnosed radiologically at the time of investigation for the primary diseaseCT scan - Presence of gas within the lumen of the bladder. Contrast may be instilled into the rectum &;on table&; prior to the acquisition of images in order to demonstrate a fistulaFluoroscopy Treatment and prognosis*Surgical resection of the fistula and abnormal segment of bowel is usually required for cure, although in the setting of malignancy this suggests advanced disease (T4) making surgery complex.*In such cases, if palliation only is required then de-functioning colostomy, colonic stent placement or a nephrostomy may be required.(Refer: )