Print This Page     Close Window Consult Request Guidelines for Fistula Enteroentero, Enterovaginal, Enterovesical, Enterocutaneous     Fistula Enteroentero, Enterovaginal, Enterovesical, Enterocutaneous Suggested Pre-Referral Evaluation and Management Guidelines Referral is indicated if the patient has: enteroentero 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. 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) www.fascrs.org/ Appointment Timeframe 2-3 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 Karin M Hardiman, MD Arden Marie Morris, MD Scott E Regenbogen, MD Revised on: 09/19/2012