Penetration of Sigmoid Colon Diverticulitis to the Left Uterine Adnexa Causing Ovarian Abscess Concomitantly—Report of a Case—

Abstract

A 72-year-old woman presented with tarry stool and left lower-quadrant pain. An abdominal contrast-enhanced CT scan revealed multiple diverticula arisen in the sigmoid colon ; from where an area of hyper absorption continuously extended to the left uterine adnexa ; and an area of low absorption and extraintestinal gas were associated in the inner part. We diagnosed the case as penetration of the sigmoid colon to the uterine adnexa secondary to diverticulitis, with abscess formation, and initiated conservative therapy. However, a CT scan showed persisting extraintestinal gas and abscess formation, and so partial sigmoidectomy and resection of the left uterine adnexa were performed. Histopathology revealed rupture of pseudodiverticulum and infiltration of inflammatory cells mainly in the subserous structure of the sigmoid colon ; and there were abscess formation composed of accumulation of neutrophiles and foreign-body type multinucleated giant cells in the left ovary. Her postoperative course was uneventful and she was discharged from our hospital on the 16^th postoperative day.

We have experienced a case of sigmoid diverticulitis penetrating the left uterine adnexa to cause an ovarian abscess. Since the case is considered very rare, we present the case together with some bibliographic comments.