A Case of Colouterine Fistula Associated with Diverticulitis of the Sigmoid Colon

Yusuke Furukawa, Sinniti Nakayama, Mitsuhiro Kawata, Tadao Sato, Hiroaki Imanishi and Tatsuya Kozuma

The Yokohama Seaman's Insurance Hospital

A 69-year-old woman who had lost about 20kg of weight in a month and reported fecal discharge from the vagina was referred to us for further avaluation. Radiographic barium examination showed diverticula with stenosis of the sigmoid colon and a sigmoid-uterine fistula. Computed tomography suggested colonic tumor invading the bladder and the uterus, but colonoscopy and a saggital view in magnetic resonance imaging disclosed no evidence of sigmoid colon cancer. Sigmoidectomy with total hysterectomy was conducted successfully under a final diagnosis of colouterine fistula associated with diverticulitis. Macroscopic findings of the resected specimen showed multiple diverticula with 2 fistulas in the sigmoid colon and a fistula on the anterior wall of the uterine cervix. Histopathological examination showed abscess in the subserosal layer of pseudodiverticula. Sigmoid-uterine fistula remains rare, but colonic diverticulosis is gradually increasing. We review 8 cases previously reported in Japan.

Key words
diverticulitis, colouterine fistula

Reprint requests
Yusuke Furukawa The Yokohama Seaman's Insurance Hospital 43-1 Kamadai-chou, Hodogaya-ku, Yokohama, 240-8585 JAPAN

Accepted
October 31, 2001

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