A Very Rare Case of Colosalpingeal Fistula Secondary to Diverticulitis: An Overview of Development, Clinical Features and Management

Abstract

Background: Colosalpingeal fistula is a rare complication secondary to diverticular disease. The pathogenesis is still not clearly understood. We present the case of a colosalpingeal fistula and a review of the management of this pathology. Case report: A 69-year-old patient with uncomplicated diverticular disease was referred to our department for recurrent vaginal discharge. The clinical examination was unremarkable, hysteroscopy revealed the presence of air in the uterine cavity in the absence of a uterine fistula. A preliminary diagnosis of colosalpingeal fistula was made and was confirmed by computed tomography (CT) scan and hysterosalpingography. A one-stage surgery via laparotomy was successfully performed with remission of the symptoms. Conclusion: Colotubal fistula is a rare complication resulting from intestinal diverticular disease. The purpose of this paper was to emphasize the presence of a rare, but serious complication occurring in diverticular disease with atypical symptoms and one-stage surgery treatment.

Colo-Fallopian Fistula: A Rare Complication of Sigmoid Colon Diverticulitis

“…Patients can also have multiple positive tests for bacterial vaginal infections. Guidelines vary from both a gynecologic and surgical standpoint [ 6 ]. Gynecologists may use transvaginal ultrasound or hysteroscopy to visualize a fistula in the uterus.…”

“…This is a possible disadvantage to recognizing and treating sigmoid fistulas appropriately. Hysterosalpingography and colonoscopy are notable in helping diagnose colo-fallopian fistulas in particular [ 6 ]. As fistula connections can form in a variety of locations, the use of more than one imaging modality may be necessary before ruling out the presence of a fistula.…”

“…Patients that are treated surgically are known to have a better improvement of their symptoms and quality of life compared to those treated conservatively. Some circumstances have reported refusal of surgical treatment or delayed treatment, which resulted in the patient’s untimely death [ 6 , 9 ]. There are also reported cases of colo-fallopian fistulas that were managed gynecologically.…”

“…Patients that present with acute complications of diverticulitis can be treated conservatively. However, since diverticula are still present, patients remain prone to recurrences of diverticulitis that may progress to chronic complications [3][4][5][6][7]. The surgical approach is a solution known to resolve a patient's symptoms [7].…”

Interventional ultrasound and contrast‐enhanced ultrasound in the diagnosis of small intestine‐iliopsoas fistula: A case report

“…At the early stage of IF the probability of diagnosis by using abdominal Xray is low. 12 However, ultrasound is more sensitive than X-ray examination as it is able to reveal gas accumulation in the abdominal cavity and the intestinal wall swelling; thus, the diagnosis can be made at the early stage of the disease. 13 The combined use of CEUS, ultrasound-guided diagnostic puncture and drainage not only can identify quickly the nature of the lesion, but contributes to the success of further systematic therapy as well.…”