A Case of Rectal and Ureteral Stricture Secondary to Pelvic Peritonitis

Abstract

We report a case of stricture of the rectum and ureter secondary to pelvic peritonitis. An intrauterine contraceptive device (IUD) had been in place for 8 years in a 40-year-old women admitted for right lower abdominal pain. Computed tomography (CT) confirmed right hydronephritis, and severe inflammation was found around the right ovary. Colonoscopy revealed complete stricture of the rectum about 25cm above the dentate line, but the rectal mucosa was smooth. A diagnosis of stricture of the rectum and ureter secondary to pelvic peritonitis was made, and surgery was performed. At laparotomy, the pelvic mass was found to consist of an infected ovarian mass that had resulted in dense fibrosis between the right fallopian tubes, ovary, rectum, ureter, and appendix. Right salpingo-oophorectomy and appendectomy were performed and the patient made an uneventful recovery. Although there have been few reports of stricture of the rectum and ureter caused by pelvic peritonitis, pelvic inflammatory disease is more likely to occur in patients with a history insertian of an IUD.