A Case of Sigmoid Colon Diverticulitis in which a Transanal Ileus Tube Inserted into the Ileum

Abstract

A 45-year-old male who had been treated conservatively for sigmoid colon diverticulitis presented with ileus. A transanal ileus tube was inserted to treat the ileus and then perform laparoscopic surgery. On the following day, the patient’s condition worsened and an emergent operation was performed. The tip of the ileus tube had entered the ileum through a coloileal fistula. We performed sigmoidectomy and ileocecal resection, with a double-barrel ileostomy. Sigmoid diverticulitis causes fistula formation with the surrounding organs, and a few cases of development of a coloileal fistula have been reported. Transanal drainage is a common technique for treating ileus associated with lesions of the rectum or sigmoid colon. In the X-ray obtained after the insertion of the ileus tube, the transanal ileus tube was not detected in the ileum. Fistula formation must be kept in mind when transanal drainage is performed for ileus caused by colon diverticulitis.