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
UMHS Patients: See MiChart
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
1500 East Medical Center Drive, SPC 5343
Ann Arbor, MI 48109-5343