A CASE OF SIGMOIDOVAGINAL FISTULA SECONDARY TO DIVERTICULITIS

Colovaginal fistula from any cause is rare and represents 1.2% of all fistulae, though diverticular disease is the most common cause of the disease. A 68-year-old female was referred to the surgical department because of lower abdominal pain and stool from the vagina. There was a slight tenderness in the lower abdomen, but no muscular defense nor Blumberg symptoms were noted. On barium enema examination, multiple diverticula in the entire colon and a sigmoidovaginal fistula were found. Endoscopically, the color of the mucosa was reddish, but the opening to the fistulous tract was not found. On abdominal CT with contrast enema, barium was found in the diverticula. The diagnosis of sigmoidovaginal fistula was made. Sigmoidectomy including the fistula with diverticula was performed because of multiple diverticula in the entire colon. Postoperative course was uneventful and the patient was discharged from the hospital three weeks after the operation.