A Case of Sigmoid Colon Diverticulitis which Formed Multiple Fistulae after Constructing a Stoma

Abstract

Colic diverticulitis is a commonly encountered disease, but there have been few reports of cases with a fistula formed in a neighboring organ. Furthermore, there have been no reports in Japan of multiple fistulae occurring after constructing a stoma in the mouth side of the lesion. The present case was a 64-year-old woman. We constructed a stoma of the transverse colon for obstruction of the sigmoid colon, and tried to resect the stenosis department for the second, but were forced to abandon the procedure due to strong adhesion to the neighboring region. We confirmed a sigmoid colic-ileal fistula by enema examination approximately one year later, but followedup the case because there were no subjective symptoms. Approximately two years and six months later, she complained of a slight fever and a left inguinal ache, and we confirmed an abscess from the left iliopsoas to the hip joint in abdominal CT. A thorough investigation after percutaneous drainage showed that the abscess penetrated to the retro-peritoneum and formed abscess other than sigmoid colic-ileal fistula. We diagnosed multiple fistulae due to chronic inflammatory disease of the colon and performed a sigmoid colon resection and ileal segmental resection. Perforation due to chronic inflammation of the sigmoid colon diverticulum was diagnosed by histopathological examination.