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Laparoscopic sigmoidectomy combined with uterus excision for colouterine fistula caused by sigmoid colon diverticulitis: A case report
Author(s) -
Arakawa Satoshi,
Morise Zenichi,
Isetani Masashi,
Tomishige Hirokazu,
Kawabe Norihiko,
Nagata Hidetoshi,
Asano Yukio,
Kawase Jin,
Kamio Kenshiro,
Imaeda Yoshihiro,
Umemoto Shunji,
Ikeda Masahiro,
Horiguchi Akihiko
Publication year - 2017
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12378
Subject(s) - medicine , diverticulitis , sigmoid colon , surgery , fistula , white blood cell , abdomen , laparoscopy , uterus , gastroenterology , rectum
Abstract A case of colouterine fistula caused by colonic diverticulitis that was successfully treated laparoscopically is presented. A 74‐year‐old woman visited us with lower abdominal discomfort and vaginal excretion with minor fecal contamination. Mild tenderness was observed in her lower abdomen. Blood examinations revealed elevated white blood cell count and C‐reactive protein. Sigmoid colon diverticulitis was revealed on CT, and her condition was diagnosed as colouterine fistula. Hinchey classification was stage I. After 2 weeks of conservative therapy, her symptoms were reduced, and the white blood cell count and C‐reactive protein level decreased. However, fecal contaminated vaginal excretion continued. The patient underwent laparoscopic sigmoidectomy combined with uterus excision, and she has been in good health for the 3 years since the operation. Although colouterine fistula is usually treated with open surgery, patients with controlled and well‐localized inflammation may be good candidates for a laparoscopic approach.