A Case of Sigmoid-vaginal Fistula Secondary to Diverticulitis after Total Hysterectomy

Abstract

A 61-year-old female with a history of undergoing total hysterectomy and bilateral salpingo-oophorectomy for atypical endometrial hyperplasia at the age of 55 presented at our hospital because of pus-like discharge from the vagina lasting for three weeks. Abdominal enhanced CT scan revealed multiple diverticula of the sigmoid colon with surrounding inflammation. The sigmoid colon was connected to the vaginal stump with a band-like structure and the formation of a fistula was suspected. Colposcopy revealed a fistula on the vaginal end, and contrast examination from the vagina showed that the fistula was connected to the sigmoid colon. Under the diagnosis of sigmoid-vaginal fistula secondary to diverticulitis the of sigmoid colon, we performed laparoscopic rectal low anterior resection and ileostomy construction. The vaginal side of the fistula was closed with sutures. Closure of the ileostomy was performed four months postoperatively.