Colo-ovarian Fistula complicating acute diverticulitis: Two cases and literature review

Colonic diverticulosis is common in western world. Fistula formation occurs in 10-20 % of patients, usually as a consequence of an acute inflammatory process (diverticulitis). Fistulas from diverticulitis occur mainly to bladder, small bowel and uterus. Communication between colon and ovary occurred more frequently in the context of primary neoplasms of ovary, ovarian abscess or Crohn's disease. However, colo-ovarian fistula after acute colonic diverticulitis is a rare entity with few cases reported in literature.

In this article, we described two cases. We also performed a literature review. In both cases, an initial conservative management for acute diverticulitis was performed. The maintenance of symptoms dictated further investigation. The presence of left ovarian abscess was presented, suggesting the presence of fistula.

Although the distinct evolution during the initial treatment, which results in different timing for surgery, en bloc resection of colon and adnexa was performed, with favorable outcomes. Final pathological analysis confirmed the diagnosis.

Colo-ovarian fistulas complicating acute diverticulitis are rare entities. In this article, we present our experience in the management of two cases, with different surgical approach but favorable outcomes.