Different etiologies of an unusual disease: Colouterine fistula – Report of two cases

Abstract

Colouterine fistula is an extremely rare condition, as the uterus is a thick, muscular organ. Here, we present two different etiologies for this rare condition—diverticulitis and malignancy. A 77-year-old female with colouterine fistula due to diverticulitis presented with complaints of lower abdominal pain localized particularly in the left iliac fossa and fever. Another case was of 73-year-old female with colouterine fistula due to malignancy who presented with abdominal pain, blood in stools, and whitish discharge from vagina. Both cases were evaluated with contrast-enhanced computed tomography (CECT). The presence of air and fluid within the uterus on ultrasound or CT scan, prompts the possibility of colouterine fistula with CECT providing accurate preoperative assessment.

Keywords

Colon - diverticulitis - fistula - malignancy - uterus

• References

• 1 Mandato VD, Abrate M, Sandonà F, Costagliola L, Gastaldi A, La Sala GB. Colouterine fistula complicating diverticulitis diagnosed at hysteroscopy: Case report. J Minim Invasive Gynecol 2012; 19: 118-21
• 2 Choi PW. Colouterine fistula caused by diverticulitis of the sigmoid colon. J Korean Soc Coloproctol 2012; 28: 321-4
• 3 Uzan J, Koskas M, Fournier P, Margulies AL, Luton D, Yazbeck C. Colouterine fistula after polymyomectomy: A case report. J Med Case Rep 2014; 8: 199
• 4 Tsai YF, Chen WY, Chiao CF, Wang TL, Lin AC. A 78-year-old woman with fecaloid vaginal discharge. Emergency 2015; 3: 168-9
• 5 Sessa B, Galluzzo M, Ianniello S, Pinto A, Trinci M, Miele V. Acute Perforated Diverticulitis: Assessment with multidetector computed tomography. Semin Ultrasound CT MR 2016; 37: 37-48
• 6 Banu LH, Siddiqua A, Siddique S. Colouterine Fistula. J Bangladesh Coll Phys Surg 2017; 35: 31-3
• 7 Ben Maamer A, Zaafouri H, Noomene R, Haoues N, Bouhafa A, Oueslati A. et al. Colouterine fistula complicating diverticulitis. Tunis Med 2013; 91: 617-8
• 8 Onur MR, Akpinar E, Karaosmanoglu AD, Isayev C, Karcaaltincaba M. Diverticulitis: A comprehensive review with usual and unusual complications. Insights Imaging 2017; 8: 19-27
• 9 Mohamed A, Al Suhaibani V, Emran F, Al Shami S. Colo-uterine Fistula, a rare complication of diverticular disease of the colon, case report and literature review. Internet J Surg 2009; 25
• 10 Mazur MT, Hsueh S, Gersell DJ. Metastases to the female genital tract. Analysis of 325 cases. Cancer 1984; 53: 1978-84
• 11 Takada T, Nakagawa S, Hashimoto K, Sone K, Kugu K, Kozuma S. et al. Preoperative diagnosis of colouterine fistula secondary to diverticulitis by sonohysterography with contrast medium. Ultrasound Obstet Gynecol 2004; 24: 682-3
• 12 Kassab A, El-Bialy G, Hashesh H, Callen P. Magnetic resonance imaging and hysteroscopy to diagnose colo-uterine fistula: A rare complication of diverticulitis. J Obstet Gynaecol Res 2008; 34: 117-20
• 13 Beattie GC, Nelson M, McMillen IM, McMurray AH. Colouterine fistula mimicking pyometrium-diagnosis established with multi-detector computed tomography. Ulster Med J 2005; 74: 51-3
• 14 Blake MA, Singh A, Setty BN, Slattery J, Kalra M, Maher MM. et al. Pearls and pitfalls in interpretation of abdominal and pelvic PET-CT. Radiographics 2006; 26: 1335-53
• 15 Huettner PC, Finkler NJ, Welch WR. Colouterine fistula complicating diverticulitis: Charcoal challenge test aids in diagnosis. Obstet Gynecol 1992; 80: 550-2