Colo-Ovarian Fistula With a Background of Endometriosis: A Report of Three Cases

Patients with endometriosis are at a high risk of developing pelvic inflammatory disease. This case series presents three cases of colo-ovarian fistulas associated with endometriosis, highlighting the potential for conservative management in selected cases. Case 1 involved a 36-year-old woman in whom suspected communication between the colon and an endometriotic cyst was noted on computed tomography and magnetic resonance imaging (MRI). Case 2 involved a 42-year-old woman who presented with a colo-ovarian fistula on MRI. Case 3 involved another 42-year-old woman with a sigmoid colon perforation who was retrospectively diagnosed with a colo-ovarian fistula. All cases were associated with endometriosis. In Cases 1 and 2, symptoms were successfully managed conservatively. In Case 3, the colo-ovarian fistula only became apparent following hysterectomy and was treated by surgery. Although surgical intervention is commonly performed for colo-ovarian fistulas, our findings suggest that conservative treatment may be an option in select cases with endometriosis-associated fistulas.