Abstract
A 33-year-old man was diagnosed with sigmoid diverticulitis at a local clinic and underwent in-patient treatment. His abdominal pain failed to improve, and four days after discharge he was examined at our hospital. He was prescribed oral antibiotics as an outpatient and kept under observation, but as his abdominal pain persisted and pain on urination also appeared, he was referred to the Department of Surgery and admitted as an emergency patient. Pneumaturia and pyuria were evident, and abdominal CT revealed air retention in the bladder, while plain pelvic MRI revealed a fistula and vesico-sigmoid fistula was diagnosed. Cystoscopy revealed severe inflammatory lesions near the trigone of the bladder, but the fistula and ureteral orifice were unclear. Surgery was therefore postponed while a transverse colostomy was created, and sigmoid colectomy and bladder repair were performed six months later as combined cystocopic and laparoscopic surgery. The colostomy was closed after another month. The patientʼs subsequent course has been uneventful, with no recurrence.
