1994 Volume 36 Issue 4 Pages 771-775_1
A 66-year-old man with a complaint of left lower abdominal pain admitted to our medical center. An intraperitoneal abscess with sigmoid fistula was diagnosed by Barium enema, CT and colonoscopy. A sigmoidal fistula was not detected macroscopically during operation, but intraoperative colonoscopy revealed whitely coated spot and proved it to be an entry of the colonic fistula. The final diagnosis obtained by pathological findings was an appendico-sigmoid fistula due to acute appendicitis. Twelve cases of appendicoenter-of fistula have been reported in Japan. Barium enema has been said to be useful for the diagnosis of this disorder. But in our case endoscopic examination was more valuable for the diagnosis and treatment.
