A Case of Sigmoid Diverticulitis Developing a Fistula through an Abscess in the Broad Ligament of the Uterine

Abstract

Sigmoid diverticulitis rarely develops a fistula to the urinary bladder, often requiring a difficult and long-term treatment. We report a case of a patient suffering from a colovesical fistula through an abscess in the broad ligament of the uterine. A woman 49-year-old was presented to a clinic with repeated pain when urinating for 8 months. She was referred to our hospital with a diagnosis of colovesical fistula due to gas image in the urinary bladder by a CT scan. A CT scan soon after gastrografin enema during sigmoidoscopy showed a contrasted urinary bladder including both renal pelves, suggesting the presence of a fistula. Then we performed laparoscopic surgery with the diagnosis of colovesical fistula. Sigmoid diverticulitis firmly adhered to the urinary bladder through the left side of the broad ligament of uterine. After breaking up adhesions and confirming a negative leak test from the bladder, we performed partial sigmoidectomy without repair of the bladder. Her postoperative course was uneventful and she was discharged on the 11th day postoperatively. No evidence of recurrence was seen for these 2 years.