Abstract
We report a very rare case of ureterocolic fistula caused by colonic diverticulitis in a 52-year-old man. The patient was readmitted for sigmoidectomy and closure of a colostomy 12 month after the initial surgical procedure which had consisted of temporary transverse colostomy, lavage, and drainage for diffuse peritonitis caused by colonic diverticulitis. Physical examination at the time of the second admission revealed pneumaturia and an infected surgical scar in the lower abdomen. A double-contrast barium enema and fistulography through the surgical scar showed fistulas between the skin, sigmoid colon, and left ureter. Since the left kidney was functioning, sigmoidectomy with preservation of the left ureter was performed. Because of the severe adhesion, the location of the fistula could not be identified. We were able to dissect the severe adhesion guided by a palpable ureteral stent and to avoid damaging the ureter, even though the ureterocolic fistula was transected during the dissection. The postoperative course was uneventful and on postoperative day 14 the ureteral catheter was removed and the patient discharged.
