Colouterine Fistula and Pyometra Caused by Diverticulitis of the Sigmoid Colon—A Report of Three Cases—

Abstract

Case 1 : A 61-year-old woman presented with abdominal pain. Computed tomography (CT) showed an unclear boundary between the sigmoid colon with diverticula and the uterus, as well as gas in the uterus. The patient was diagnosed with a colouterine fistula caused by diverticulitis and underwent sigmoidectomy. Case 2 : An 81-year-old woman with anemia presented following vaginal drainage with pyometra. CT showed fluid collection with gas in the uterus. Barium enema showed diverticula of the sigmoid colon and outflow of barium from the colon. The patient was diagnosed to have pyometra due to a colouterine fistula caused by diverticulitis and underwent sigmoidectomy with closure of the fistula. Case 3 : An 85-year-old woman presented with abdominal pain. CT showed free air, diverticula of the sigmoid colon, and a pelvic abscess. Suspecting perforation of the sigmoid colon diverticula, surgery was performed. Laparotomy showed perforation of pyometra due to a colouterine fistula caused by diverticulitis. Sigmoidectomy and hysterectomy were then performed. Three extremely rare cases of colouterine fistula and pyometra caused by diverticulitis are described.