A case of sigmoid vaginal fistula due to diverticulitis treated with laparoscopic surgery

Abstract

We report a case of sigmoid-vaginal fistula, due to diverticulitis of the sigmod colon, treated with laparoscopy assisted surgery. A 77-year-old female who had undergone total hysterectomy at the age of 37 and laparoscopic assisted distal gastrectomy at the age of 76 was admitted because of stool-like discharge from the vagina. Endoscopic and radiological examinations showed multiple diverticulae of the sigmoid colon with the formation of a fistula communicating with the vagina.
Laparoscopy-assisted sigmoidectomy was done. Dissection of the mesentery was done by the medial approach and the stump of the vagina was not closed because the fistula adhered to the bladder. Her postoperative clinical course was uneventful except for wound infection. The stool-like discharge from the vagina disappeared. Two cases of laparoscopy-assisted surgery for sigmoid-vaginal fistula have been reported in Japan. Laparoscopic surgery was thought to be an option for fistula due to diverticulitis.