CONSULT REQUEST GUIDELINES                                                                         Print

Enteroentero, Enterovaginal, Enterovesical, Enterocutaneous

Suggested Pre-Referral Evaluation and Management Guidelines Referral is indicated if the patient has:
  • enteroenteric fistula diagnosed by radiologic imaging.
  • enterovaginal fistula diagnosed by symptomatology consisting of stool being expelled from the vagina and/or history and physical findings supporting the existence of such fistula. Patients with low rectovaginal fistula, especially those that result from obstetric trauma, may be referred to the Urogynecology group.
  • enterovesical fistula diagnosed by symptomatology consisting of pneumaturia or fecaluria in a patient who has risk factors for fistula formation. Confirmation by cystogram and/or cystoscopy is preferred.
  • enterocutaneous fistula diagnosed by symptoms and physical findings in a patient with risk factors for fistula formation and/or diagnosed by radiologic imaging.
If patient has been managed external to the UMHS system, fax radiologic imaging reports, endoscopy and biopsy reports for patients with confirmed inflammatory bowel disease, and operative reports from any procedures performed on the bowel prior to the clinic visit. Radiologic images, on CD, should be available for review. Before the clinic visit is preferable, however, patient may hand-carry CD to the clinic visit.
Suggested Additional Test/Management Prior to Specialty Visit  
Patient Education/Information (includes preps)
Appointment Timeframe 2-4 weeks
How to Get Results to Consultant UMHS Patients: See MiChart
External Patients:
Reports and/or medical records can be faxed to 734-232-6189

CDs can be hand-carried to the appointment

Reports, medical records, CDs, and pathology slides can be mailed to:
Division of Colorectal Surgery
Attention: Jain Carver
2124 Taubman
1500 East Medical Center Drive, SPC 5343
Ann Arbor, MI 48109-5343
Clinic Contact Information Physicians: 800-962-3555
Patients: 734-615-7565
Clinic Location Sites Colorectal Surgery Clinic
UM Consulting Physician Colorectal Surgery Physicians
Revised on: 04/21/2015



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