Management of Lumbar Abscess Secondary to Colocutaneous Fistula From Complicated Diverticular Disease Using Negative Pressure Therapy.

Diverticular disease is a common gastrointestinal condition with rising prevalence. Complications, such as fistulas, are rare but significant, often requiring innovative treatment strategies. This case report examines the use of negative pressure wound therapy (NPWT) with instillation (VERAFLO®, KCI, an Acelity Company, San Antonio, Texas) and antiseptic solution (VASHE®, Urgo Medical North America LLC, Fort Worth, Texas) in treating a colocutaneous fistula secondary to complicated diverticular disease. A 43-year-old male presented with lumbar pain and erythema. Computed tomography (CT) scans revealed a left-sided collection with gas, suggesting a colocutaneous fistula. Initial management included drainage, antibiotics, and NPWT. Follow-up involved transrectal contrast CT to assess the fistula tract and subsequent colonoscopy to confirm resolution. NPWT with VERAFLO® was applied for 20 days, followed by wound closure. Two-month follow-up showed no evidence of fistula on colonoscopy, confirming successful treatment. NPWT can be an effective alternative for treating colocutaneous fistulas in diverticular disease, promoting wound healing and reducing infection. Further research is warranted to explore its broader applications in gastrointestinal fistulas.