Complicated Colonic Diverticulitis Presenting as Vaginal Bleeding: An Unusual Presentation

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Colonic diverticula represent outpouchings of the colonic mucosa through the muscularis propria.
• Diverticulitis, the inflammation of these diverticula, commonly presents with left lower quadrant abdominal pain, fever, and altered bowel habits.

Observation:

• A patient presented with symptoms suggestive of complicated colonic diverticulitis.
• The presentation included vaginal bleeding and pelvic pain, which are atypical for standard diverticulitis.

Findings:

• The patient was diagnosed with a colonic diverticulitis complicated by a vaginal fistula.
• An abdominal abscess was identified as a sequela of the fistula formation.

Implications:

• This case underscores the importance of considering rare complications in the differential diagnosis of atypical abdominal and pelvic pain.
• Vaginal fistulas secondary to diverticulitis, though uncommon, require prompt recognition and management to prevent further morbidity.
• The unusual presentation emphasizes the need for thorough diagnostic workups in cases of complicated diverticular disease.