International journal of surgery case reports · 2026
Complicated sigmoid diverticulitis causing colouterine fistula and recurring tubo-ovarian abscesses: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hers Felix, Vuylsteke Ronald J C L M, van Swieten Esther C A M, Stockmann Hein B A C
Аннотация
INTRODUCTION: Diverticulitis is an inflammatory disease of the intestine that can lead to complications such as perforation, abscesses, and fistulas, including a colouterine fistula. Colouterine fistulas are rare, certainly in combination with a tubo-ovarian abscess (TOA), and the literature on this topic is scarce.
CASE PRESENTATION: We report the case of a 54-year old woman with recurrent intra-abdominal and tubo-ovarian abscesses and a colouterine fistula due to complicated sigmoid diverticulitis. The patient initially presented with left iliac fossa pain, fever, and altered bowel habits, without vaginal or urinary symptoms. Her medical history included a left-sided ectopic pregnancy and previous episodes of diverticulitis. Treatment consisted of intravenous (IV) antibiotics, radiological and surgical drainage, and eventually Hartmann's procedure with a salpingo-oophorectomy. Histopathology confirmed the presence of a TOA and a fistula.
DISCUSSION: This case highlights the diagnostic difficulty in distinguishing complicated diverticulitis from pelvic inflammatory disease (PID) as a cause of a TOA in the presence of a colouterine fistula, especially when CT imaging shows no signs of the fistula or of active diverticulitis. A multidisciplinary approach involving gynecology, radiology and surgery contributed to achieving a successful outcome. Furthermore, this case suggests that a colouterine fistula caused by complicated diverticulitis can be managed with Hartmann's procedure without hysterectomy.
CONCLUSION: Clinicians should consider complicated diverticulitis as a potential cause of TOA, even in the absence of radiologic signs. Multidisciplinary collaboration and individualized surgical management are essential for optimal outcomes in these rare and complex cases.
CASE PRESENTATION: We report the case of a 54-year old woman with recurrent intra-abdominal and tubo-ovarian abscesses and a colouterine fistula due to complicated sigmoid diverticulitis. The patient initially presented with left iliac fossa pain, fever, and altered bowel habits, without vaginal or urinary symptoms. Her medical history included a left-sided ectopic pregnancy and previous episodes of diverticulitis. Treatment consisted of intravenous (IV) antibiotics, radiological and surgical drainage, and eventually Hartmann's procedure with a salpingo-oophorectomy. Histopathology confirmed the presence of a TOA and a fistula.
DISCUSSION: This case highlights the diagnostic difficulty in distinguishing complicated diverticulitis from pelvic inflammatory disease (PID) as a cause of a TOA in the presence of a colouterine fistula, especially when CT imaging shows no signs of the fistula or of active diverticulitis. A multidisciplinary approach involving gynecology, radiology and surgery contributed to achieving a successful outcome. Furthermore, this case suggests that a colouterine fistula caused by complicated diverticulitis can be managed with Hartmann's procedure without hysterectomy.
CONCLUSION: Clinicians should consider complicated diverticulitis as a potential cause of TOA, even in the absence of radiologic signs. Multidisciplinary collaboration and individualized surgical management are essential for optimal outcomes in these rare and complex cases.