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Colouterine fistula secondary to diverticulitis
Diseases of the Colon and Rectum
|May 1, 1985
Summary
Colouterine fistula, a rare complication of diverticulitis, presents with varied symptoms from chronic discharge to sepsis. Surgical management depends on presentation, ranging from sigmoid resection to en bloc hysterectomy and colon resection.
Area of Science:
- Gastroenterology and Gynecology
- Surgical Management of Complex Fistulas
Background:
- Colouterine fistula is an uncommon complication arising from diverticulitis.
- Clinical manifestations can range widely, from subtle chronic symptoms to severe acute sepsis.
Observation:
- Two patient cases highlight the diverse clinical spectrum of colouterine fistula.
- One patient presented with chronic vaginal discharge, while the other experienced acute overwhelming sepsis.
Findings:
- Surgical intervention is crucial for managing infectious complications.
- For chronic cases, a single-stage sigmoid resection may suffice.
- When malignancy is suspected, en bloc resection of the uterus and colon is recommended.
Implications:
- Hysterectomy may be necessary to address acute infection foci.
- Urgent cases with inflammation or obstruction benefit from a two-stage procedure (resection with colostomy, followed by reanastomosis).