Abstract
We report a case of laparoscopic sigmoidectomy for a vesicosigmoidal fistula caused by diverticulitis of the sigmoid colon. The disease is rare ; however, it appears to be on an increasing trend in Japan.
A 44-year-old man with pneumaturia and fecaluria came to our hospital. A barium enema revealed inflammatory stenosis of the sigmoid colon around the diverticula. CT and MRI showed a fistula and also showed that a diverticulum had adhered to the bladder, which contained air. No malignancy was found and vesicosigmoidal fistula caused by diverticulitis of the sigmoid colon was diagnosed. Laparoscopic sigmoidectomy was performed. The firm adhesion of the sigmoid colon and the bladder around the fistula was divided with sufficient recognition and preservation of important organs such as the ureter. After adhesiolysis, the bladder was filled with saline solution containing indigo carmine to ensure that there was no leakage, and no treatment was performed for the bladder except an intravesical catheter for 6 days. The postoperative course was uneventful.
Patients benefit greatly from treatment by less invasive surgery, which allows them to make an early return to society.
