2024 Volume 66 Issue 7 Pages 1472-1477
A 74-year-old man with a history of chronic pancreatitis underwent follow-up contrast-enhanced abdominal computed tomography that revealed an elevated rectal lesion. CS revealed an edematous, elevated lesion in the rectum with a positive cushion sign and stenosis in the sigmoid colon, which was difficult to pass the scope through. CS under fluoroscopy was planned; however, the contrast agent could not reach the oral aspect of the stenosis. A guidewire was advanced toward the oral aspect of the stricture under catheter guidance. The guidewire appeared from the elevated rectal lesion, confirming the diagnosis of a sigmoidorectal fistula. The patient subsequently underwent laparoscopic low anterior resection on a standby basis. The resected specimen showed multiple diverticula in the sigmoid colon and the pathological diagnosis revealed a sigmoidorectal fistula formed by diverticulitis. The elevated lesion in the rectum was thought to be a temporary change during the course of fistula formation.
