A Case of Colouterine Fistula Due to Diverticulitis Diagnosed in a Patient with Uterine Pyometra and Liver Abscess

Abstract

A 77-year-old woman visited the emergency room with the complaints of fever and white vaginal discharge. Computed tomographic examination revealed uterine pyometra, and we treated her by uterine drainage and administration of antimicrobial agents. Two months later, she visited the emergency room again with a history of generalized malaise and fever. Abdominal CT showed a liver abscess and a sigmoid-uterine fistula. We considered that the uterine pyometra and liver abscess were caused by the sigmoid-uterine fistula. After drainage of the liver abscess, we performed a laparoscopic colostomy to control the local inflammation. After three months, we performed a radical operation. As the sigmoid colon was found to be adherent to the uterus, we performed sigmoid colon resection, total hysterectomy, and bilateral adnexectomy. Histopathological examination revealed that the fistula was caused by penetration of a sigmoid colon diverticulum. We report this case of a sigmoid-uterine fistula, with a review of the literature.