Advertisement

Colouterine fistula complicating diverticulitis: a case report and review of the literature

      Abstract

      Colouterine fistula, secondary to diverticulitis, is an extremely rare complication, and only few cases have been reported in the literature. We report the case of 76-year-old woman, who presented with vaginal discharge over a three-month period. Pelvic examination and laboratory investigations suggested a colouterine fistula, that was confirmed by non-invasive imaging. Surgical treatment was a one-stage, en bloc resection of the uterus and sigmoid colon. In the presence of severe inflammatory reaction or paracolic abscess, a two-stage procedure should be safer. Otherwise, a one-stage procedure, en bloc resection of the uterus and sigmoid colon is preferred, as we cannot rule out a malignancy prior to surgery.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Jones D.J.
        Diverticular disease.
        Br. Med. J. 1992; 304: 1435-1437
        • Colcock B.P.
        • Stahmann F.D.
        Fistulas complicating diverticular disease of the sigmoid colon.
        Ann. Surg. 1972; 175: 838-846
        • Cappele O.
        • Scotté M.
        • Songne B.
        • Sibert L.
        • Michot F.
        • Tenière P.
        Treatment of colovesical: predictive factors of the maintenance of long-term digestion continuity.
        Ann. Chir. 2001; 126: 751-755
        • Lejemtel P.
        Des fistules intestino-utérines.
        Archives Provinciales de Chirurgie. 1909; 18: 628-654
        • Martin D.H.
        • Hixon C.H.
        • Wilson E.C.
        Enterouterine fistula.
        Obstet. Gynecol. 1956; 7: 466-469
        • Kirchner W.C.
        Sigmoid-uterine fistula.
        Am. J. Obstet. Gynecol. 1933; 25: 241-251
        • Hawkes S.Z.
        Enterouterine fistula.
        Am. J. Obstet. Gynecol. 1946; 52: 150-153
        • Noecker C.B.
        Perforation of sigmoid and small bowed into the uterus: secondary to diverticulitis of the sigmoid.
        Penn. Med. J. 1929; 32: 496
        • Walker J.D.
        • Gray Sr., L.A.
        • Polk Jr., H.C.
        Diverticulitis in women: an unappreciated clinical presentation.
        Ann. Surg. 1977; 185: 402-405
        • Chaikof E.L.
        • Cambria R.P.
        • Warshaw A.L.
        Colouterine fistula secondary to diverticulitis.
        Dis. Colon Rectum. 1985; 28: 358-360
        • Smalley M.A.
        • LoRusso V.
        • O’Brien J.E.
        Sigmoidouterine fistula complicating diverticulitis: report of a case.
        JAMA. 1957; 165: 827-828
        • Hershey S.J.
        Entero-uterine fistulas: report of a case of cervicosigmoidal fistula.
        Obstet. Gynecol. 1959; 14: 234-238
        • Johnston M.H.
        • Stubbs G.M.
        Sigmoidouterine fistula complicating diverticulitis: report of a case.
        Ann. Surg. 1955; 141: 138-140
        • Pickles B.G.
        A case of utero-colic fistula due to diverticulitis.
        J. Obstet. Gynaecol. Br. Emp. 1957; 64: 252-254
        • Huettner P.C.
        • Finkler N.J.
        • Welch W.R.
        Colouterine fistula complicating diverticulitis: charcoal challenge test aids in diagnosis.
        Obstet. Gynecol. 1992; 80: 550-552
        • Clay R.C.
        • Tiernay N.A.
        One-stage, en bloc resection for colonic-uterine fistula caused by diverticulitis.
        JAMA. 1969; 207: 555-557
        • Nistri R.
        • Basili G.
        • Vitali A.
        • Carrieri P.
        • Nardi S.
        Colo-uterine fistula, a complication of sigma diverticulitis.
        Minerva Chirurgica. 1998; 53: 827-830