Quintela Catarina, Santos Cláudia, Silva Ana Catarina, Barbosa Eva, Silva António Rodrigues, Silva Artur
Hospital Pedro Hispano - Department of Surgery, Matosinhos. R. de Dr. Eduardo Torres, Sra. da Hora, Matosinhos, Portugal.
Hospital Pedro Hispano - Department of Surgery: Colo-rectal Surgery, Matosinhos, Portugal.
Int J Surg Case Rep. 2020;77:476-482. doi: 10.1016/j.ijscr.2020.10.144. Epub 2020 Nov 11.
Colonic diverticulosis is common in western world. Fistula formation occurs in 10-20 % of patients, usually as a consequence of an acute inflammatory process (diverticulitis). Fistulas from diverticulitis occur mainly to bladder, small bowel and uterus. Communication between colon and ovary occurred more frequently in the context of primary neoplasms of ovary, ovarian abscess or Crohn's disease. However, colo-ovarian fistula after acute colonic diverticulitis is a rare entity with few cases reported in literature.
In this article, we described two cases. We also performed a literature review. In both cases, an initial conservative management for acute diverticulitis was performed. The maintenance of symptoms dictated further investigation. The presence of left ovarian abscess was presented, suggesting the presence of fistula.
Although the distinct evolution during the initial treatment, which results in different timing for surgery, en bloc resection of colon and adnexa was performed, with favorable outcomes. Final pathological analysis confirmed the diagnosis.
Colo-ovarian fistulas complicating acute diverticulitis are rare entities. In this article, we present our experience in the management of two cases, with different surgical approach but favorable outcomes.
结肠憩室病在西方世界很常见。瘘管形成见于10% - 20%的患者，通常是急性炎症过程（憩室炎）的结果。憩室炎引起的瘘管主要发生于膀胱、小肠和子宫。结肠与卵巢之间的连通在卵巢原发性肿瘤、卵巢脓肿或克罗恩病的情况下更为常见。然而，急性结肠憩室炎后发生的结肠 - 卵巢瘘是一种罕见情况，文献报道的病例很少。
在本文中，我们描述了两例病例。我们还进行了文献综述。两例均对急性憩室炎进行了初始保守治疗。症状持续提示需进一步检查。发现存在左侧卵巢脓肿，提示存在瘘管。
尽管初始治疗期间病情演变不同，导致手术时机不同，但均对结肠和附件进行了整块切除，结果良好。最终病理分析确诊。
急性憩室炎并发的结肠 - 卵巢瘘是罕见情况。在本文中，我们介绍了两例的治疗经验，手术方式不同但结果良好。
