Choi Pyong Wha
Department of Surgery, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
J Korean Soc Coloproctol. 2012 Dec;28(6):321-4. doi: 10.3393/jksc.2012.28.6.321. Epub 2012 Dec 31.
Colouterine fistula is an extremely rare condition because the uterus is a thick, muscular organ. Here, we present a case of a colouterine fistula secondary to colonic diverticulitis. An 81-year-old woman was referred to the emergency department with abdominal pain and vaginal discharge. Computed tomography showed a myometrial abscess cavity in the uterus adherent to the thick sigmoid wall. Upon contrast injection via the cervical os for fistulography, we observed spillage of the contrast into the sigmoid colon via the uterine fundus. Inflammatory adhesion of the distal sigmoid colon to the posterior wall of the uterus was found during surgery. The colon was dissected off the uterus. Resection of the sigmoid colon, primary anastomosis, and repair of the fistula tract of the uterus were performed. The postoperative course was uneventful. This case represents an unusual type of diverticulitis complication and illustrates diagnostic procedures and surgical management for a colouterine fistula.
子宫结肠瘘极为罕见，因为子宫是一个厚实的肌肉器官。在此，我们报告一例继发于结肠憩室炎的子宫结肠瘘病例。一名81岁女性因腹痛和阴道分泌物增多被转诊至急诊科。计算机断层扫描显示子宫肌层有一个脓肿腔，与增厚的乙状结肠壁粘连。通过宫颈口注入造影剂进行瘘管造影时，我们观察到造影剂经子宫底部溢入乙状结肠。手术中发现乙状结肠远端与子宫后壁存在炎性粘连。将结肠从子宫上分离。进行了乙状结肠切除、一期吻合以及子宫瘘管修复。术后过程顺利。该病例代表了一种不寻常类型的憩室炎并发症，并说明了子宫结肠瘘的诊断方法和手术治疗。
