Colouterine fistula: A case report of a rare complication of diverticular disease managed during the pandemic

Perez, Anthony R.; Chiong-Perez, Mary Ellen; Arcilla, Crisostomo E.; Merin, John Isaac

doi:10.1016/j.ijscr.2021.01.036

Cited by 6 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinical manifestations of colouterine fistula include vaginal discharge [ 11 ]; fever and recurrent abdominal pain may not be present in the case of chronic inflammation [ 10 ]. This case report highlights a diagnostic dilemma when Ms XY presented with a 1-month history of abdominal pain and raised inflammatory markers, but there was no clinical sign of internal fistula on initial presentation.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Colouterine fistula relating to diverticulitis: a rare clinical entity

Aslam,

Lewis,

Veerasingham

et al. 2024

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Colouterine fistula is a rare but recognizable complication of diverticulitis. This case illustrates the presence of a colouterine fistula in an elderly patient who had an atypical presentation for diverticulitis. She was initially treated with intravenous antibiotics for diverticulitis with a contained abscess. This gave her an opportunity to avoid surgery. However, her sepsis failed to respond to the initial treatment. Progress computerized tomography imaging demonstrated the presence of a colouterine fistula for which she required source control. Thus she underwent laparotomy, Hartmann’s procedure, and total abdominal hysterectomy with bilateral salpingo-oophorectomy. The diagnosis of colouterine fistula was confirmed intraoperatively and on histopathology. Subsequently, the patient had an uneventful recovery following the operation. This case highlights the rarity but also the veracity of this clinical entity.

show abstract

Section: Discussionmentioning

confidence: 99%

“…For definitive treatment, surgical resection of sigmoid colon is deemed necessary [ 6 , 11 ]. En bloc resection of the uterus is mandated in cases of suspected malignancy; however, need for hysterectomy has not been established in benign cases [ 6 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Colouterine fistula relating to diverticulitis: a rare clinical entity

Aslam,

Lewis,

Veerasingham

et al. 2024

Journal of Surgical Case Reports

View full text Add to dashboard Cite

show abstract

“…It is postulated that colouterine fistula formation is not a frequent occurrence due to the thick muscular structure of the uterus that can usually provide a protective and firm barrier against an inflammatory or malignant disease, making its invasion or affection difficult. The aetiology of fistula involving the reproductive tract includes the rupture of an abscess into the adjacent viscera; malignant disease involving the gynaecologic, colon, or other pelvic organs; inflammatory bowel disease; surgery complications; and radiotherapy complications [7][8][9][10][11][12]. A colouterine fistula due to colonic chronic diverticular disease is less likely to occur.…”

Section: Discussionmentioning

confidence: 99%

Colouterine Fistula as a Rare Cause of Postmenopausal Abnormal Uterine Bleeding: A Case Report

Silva,

Monteiro,

Barbosa

et al. 2024

JCM

View full text Add to dashboard Cite

Postmenopausal abnormal uterine bleeding is a common clinical problem addressed in gynaecological practice and should prompt clinical investigation due to the significant prevalence of malignant and premalignant lesions of the endometrium in this age group. Nevertheless, other causes should be considered, since its diagnostic and therapeutic management may differ considerably. Here, we present a case of a colouterine fistula due to chronic diverticulitis presenting with postmenopausal abnormal uterine bleeding. This is an infrequent occurrence and is caused by the rupture of a diverticular abscess into the uterine wall, resulting in an inflammatory adhesion of the colon and uterus, with necrosis and subsequent fistula formation. The clinical presentation is variable and may include abdominal pain, gastrointestinal tract symptoms, vaginal discharge, and abnormal uterine bleeding. The laboratory and imaging techniques may be not completely conclusive and definitive diagnosis can be made intraoperatively. There are different treatment options, with en bloc resection and primary anastomosis being used most often, allowing complete treatment. The prognosis for a colouterine fistula secondary to diverticulitis is excellent after surgery. This case highlights the importance of clinical suspicion of an unusual cause of uterine bleeding and an effective and multidisciplinary approach that allowed complete surgical treatment and patient recovery.

show abstract

“…It is commonly caused by malignancy, radiation cervicitis, atrophic cervicitis with aging, and the use of an intrauterine device ( 1 ). Diverticular disease is one of the rarest causes of pyometra, and in almost all such cases, the inflammation of diverticulitis directly spreads toward the uterus through a fistula ( 2 - 4 ). It is quite interesting that one prior report concluded the cause of the pyometra to be a fistula between the sigmoid colon and the oviduct ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

Pyometra and Pyogenic Spondylitis with Suspected Involvement of Diverticulitis of the Sigmoid Colon

et al. 2023

View full text Add to dashboard Cite

Pyometra is a rare disease in which pus accumulates in the uterus and is typically caused by stenosis of the cervix. Only a few case reports have indicated that diverticular disease causes pyometra. We herein report an 83-year-old woman presented to our hospital with a fever, loss of appetite, general fatigue and back pain. After some inspections, she was diagnosed with pyometra and lumbar pyogenic spondylitis secondary to diverticulitis of the sigmoid colon. We performed transvaginal drainage and continued antibiotic administration for about three months. The pyometra and pyogenic spondylitis successfully resolved, and she did not experience any recurrence.

show abstract

Colouterine fistula: A case report of a rare complication of diverticular disease managed during the pandemic

Cited by 6 publications

References 27 publications

Colouterine fistula relating to diverticulitis: a rare clinical entity

Colouterine fistula relating to diverticulitis: a rare clinical entity

Colouterine Fistula as a Rare Cause of Postmenopausal Abnormal Uterine Bleeding: A Case Report

Pyometra and Pyogenic Spondylitis with Suspected Involvement of Diverticulitis of the Sigmoid Colon

Contact Info

Product

Resources

About