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Colouterine fistula relating to diverticulitis: a rare clinical entity
Anoosha Aslam1, David J Lewis1, Mayooran Veerasingham2
1Department of General Surgery, Tamworth Hospital, Dean Street, North Tamworth, NSW 2340, Australia.
Journal of Surgical Case Reports
|February 9, 2024
Summary
Colouterine fistula, a rare complication of diverticulitis, can present atypically in elderly patients. Prompt diagnosis via imaging and surgical intervention are crucial for managing sepsis and ensuring recovery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Gynecologic Oncology
Background:
- Diverticulitis is a common condition, but colouterine fistula is a rare complication.
- Atypical presentations of diverticulitis can delay diagnosis and treatment.
Observation:
- An elderly patient presented with atypical symptoms of diverticulitis, initially treated with antibiotics for a contained abscess.
- Sepsis persisted despite initial antibiotic therapy, prompting further investigation.
- Progress computerized tomography (CT) imaging revealed a colouterine fistula.
Findings:
- The colouterine fistula required source control, necessitating surgical intervention.
- The patient underwent laparotomy, Hartmann's procedure, and total abdominal hysterectomy with bilateral salpingo-oophorectomy.
- Intraoperative findings and histopathology confirmed the diagnosis of colouterine fistula.
Implications:
- This case underscores the importance of considering rare complications like colouterine fistula in patients with atypical diverticulitis presentations.
- Early and accurate diagnosis through advanced imaging is vital for effective management.
- Surgical intervention remains essential for source control in complicated cases, leading to favorable outcomes.
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