Scientific letter
Mini-invasive treatment of colouterine fistula of diverticular origin
Tratamiento miniinvasivo de la fístula colouterina de origen diverticular
Ricardo Esteban Mentz, Esteban Agustín González Salazar
, Juan Pablo Campana, Carlos Alberto Vaccaro, Gustavo Leandro Rossi
Corresponding author
Sector de Coloproctología, Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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below, the sigmoid colon adhered towards the uterus, which is being dissected with electrocautery.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Colonic diverticulosis is a common entity that causes an acute inflammatory process in approximately 20% of patients.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> About 20% of patients who undergo elective surgery for complications of diverticulosis present fistula of the colon with another organ; colovesical fistulae are the most frequent, and colouterine fistulae are among the most unusual.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Currently, the minimally invasive treatment of diverticular disease includes the use of video-assisted laparoscopic surgery<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and the application of perioperative optimization programs or Enhanced Recovery After Surgery protocols (ERAS).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 65-year-old woman with a colouterine fistula secondary to complicated diverticular disease, treated by laparoscopic resection of the sigmoid colon and preservation of the uterus within the framework of an ERAS program.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient’s history included laparoscopic surgery for endometriosis 30 years earlier, a recent colonoscopy that only showed diverticula in the sigmoid colon, smoking and obesity (BMI 32 kg/m<span class="elsevierStyleSup">2</span>). The patient consulted for purulent vaginal discharge, with no other clinical manifestations, two months after receiving medical treatment for the first episode of acute diverticulitis. During colposcopy, pus was observed coming out of the cervix, which was mildly painful upon mobilization.</p><p id="par0020" class="elsevierStylePara elsevierViewall">A double contrast barium enema was performed, which showed diverticular formations but no signs of complications. An MRI scan, however, identified a fistula between the sigmoid colon and the uterus with inflammatory characteristics (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient was included in an ERAS program. An enema was used for preoperative bowel preparation, and antibiotic prophylaxis was administered during anesthetic induction. We performed elective exploratory laparoscopy and observed an inflammatory process between the sigmoid colon and the uterus. The colouterine fistula was undone with electrocautery (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Laparoscopic sigmoidectomy was completed, with descent of the splenic angle and primary colorectal anastomosis created with double mechanical suture, following a previously described technique.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The patient evolved without complications and was discharged from the hospital on the second postoperative day. The histopathological study confirmed diverticular disease of the colon. In the outpatient follow-up visit on the seventh postoperative day, the patient presented no vaginal discharge. After 18 months of follow-up, the patient has had no complications related to the pathology treated.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Colouterine fistula secondary to diverticulitis is a rare entity with few cases reported in the international literature.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Perhaps this is because the thickness of the myometrium offers great resistance to the subacute inflammatory process that ends up communicating the lumen of the colon with the endometrium. Clinically, it manifests as purulent vaginal discharge due to the presence of fecal matter in the uterus, although it can also manifest as sepsis if there is an accumulation of pus in the uterine cavity. While not recent, the patient’s history of surgery for endometriosis is still important as it could have caused adhesions between the sigmoid colon and the myometrium, favoring the progression of the inflammatory process that began later.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The barium enema did not demonstrate the communication between the two organs, which usually happens.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Although computed tomography is very sensitive and specific for the diagnosis of acute complications of diverticulosis, identification of a fistulous tract and the diagnostic exclusion of a neoplasm are more difficult. For this reason, we used magnetic resonance imaging, which has greater precision for the diagnosis of a fistula, in addition to allowing us to determine its inflammatory characteristics.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Surgery is the definitive treatment, and <span class="elsevierStyleItalic">en bloc</span> resection of both organs is the most frequently reported strategy.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> However, there are no clear guidelines on the need for hysterectomy in cases in which there is no pyometra or manifestations of sepsis. Thus, considering that the patient did not present signs of systemic inflammation (fever, leukocytosis, etc.), we opted for a conservative strategy, performing only sigmoidectomy with primary anastomosis. Laparoscopic resection has advantages over open surgery, including less pain, shorter hospital stay and quick recovery.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> Compliance with 83% of the ERAS protocol measures in this particular case contributed to the short hospital stay and low morbidity.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Prophylactic antibiotic treatment was administered during anesthetic induction, similar to what is used for the treatment of colovesical fistulae. It was not continued during the postoperative period due to the optimal clinical condition of the patient, showing no signs of systemic inflammation before or after the procedure, and the lack of evidence for another indication.</p><p id="par0050" class="elsevierStylePara elsevierViewall">This rare entity can be treated appropriately with a minimally invasive approach and without the need for hysterectomy under the clinical conditions presented here, with early hospital discharge.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mentz RE, González Salazar EA, Campana JP, Vaccaro CA, Rossi GL. Tratamiento miniinvasivo de la fístula colouterina de origen diverticular. Cir Esp. 2021;99:549–551.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1132 "Ancho" => 1674 "Tamanyo" => 108031 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sagittal magnetic resonance image in T2 sequences with endovaginal gel. A heterogenous collection is observed at the anterior wall of the sigmoid colon (*), in contact with the uterine fundus and hyperintense linear fistula (white) through the myometrium (arrow).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1346 "Ancho" => 1674 "Tamanyo" => 224379 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The colouterine fistula is observed (arrow); below, the sigmoid colon adhered towards the uterus, which is being dissected with electrocautery.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and pathogenesis of diverticular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.P. Heise" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11605-008-0492-0" "Revista" => array:6 [ "tituloSerie" => "J Gastrointest Surg" "fecha" => "2008" "volumen" => "12" "paginaInicial" => "1309" "paginaFinal" => "1311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18278535" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laparoscopic sigmoidectomy combined with uterus excision for colouterine fistula caused by sigmoid colon diverticulitis: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Arakawa" 1 => "Z. Morise" 2 => "M. Isetani" 3 => "H. Tomishige" 4 => "N. Kawabe" 5 => "H. Nagata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ases.12378" "Revista" => array:7 [ "tituloSerie" => "Asian J Endosc Surg" "fecha" => "2017" "volumen" => "10" "paginaInicial" => "415" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28557372" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0025775310007505" "estado" => "S300" "issn" => "00257753" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practice parameters for the treatment of sigmoid diverticulitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Feingold" 1 => "S.R. Steele" 2 => "S. Lee" 3 => "A. Kaiser" 4 => "R. Boushey" 5 => "W.D. Buie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DCR.0000000000000075" "Revista" => array:6 [ "tituloSerie" => "Dis Colon Rectum" "fecha" => "2014" "volumen" => "57" "paginaInicial" => "284" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24509449" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS) society recommendations: 2018" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U.O. Gustafsson" 1 => "M.J. Scott" 2 => "M. Hubner" 3 => "J. Nygren" 4 => "N. Demartines" 5 => "N. Francis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00268-018-4844-y" "Revista" => array:6 [ "tituloSerie" => "World J Surg" "fecha" => "2019" "volumen" => "43" "paginaInicial" => "659" "paginaFinal" => "695" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30426190" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two-day hospital stay after laparoscopic colorectal surgery under an enhanced recovery after surgery (ERAS) pathway" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Rossi" 1 => "H. Vaccarezza" 2 => "C.A. Vaccaro" 3 => "R.E. Mentz" 4 => "V. Im" 5 => "A. Alvarez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00268-013-2155-x" "Revista" => array:7 [ "tituloSerie" => "World J Surg" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "2483" "paginaFinal" => "2489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23881088" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1888441518301711" "estado" => "S300" "issn" => "18884415" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Right versus left laparoscopic colectomy for colon cancer: does side make any difference?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.P. Campana" 1 => "P.A. Pellegrini" 2 => "G.L. Rossi" 3 => "G. Ojea Quintana" 4 => "R.E. Mentz" 5 => "C.A. Vaccaro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00384-017-2776-x" "Revista" => array:6 [ "tituloSerie" => "Int J Colorectal Dis" "fecha" => "2017" "volumen" => "32" "paginaInicial" => "907" "paginaFinal" => "912" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28204867" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colouterine fistula complicating diverticulitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ben Maamer" 1 => "H. Zaafouri" 2 => "R. Noomene" 3 => "N. Haoues" 4 => "A. Bouhafa" 5 => "A. Oueslati" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Tunis Med" "fecha" => "2013" "volumen" => "91" "paginaInicial" => "617" "paginaFinal" => "618" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24282010" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colouterine fistula caused by diverticulitis of the sigmoid colon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.W. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3393/jksc.2012.28.6.321" "Revista" => array:6 [ "tituloSerie" => "J Korean Soc Coloproctol" "fecha" => "2012" "volumen" => "28" "paginaInicial" => "321" "paginaFinal" => "324" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23346512" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Colouterine fistula complicating diverticulitis: a case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Sentilhes" 1 => "O. Foulatier" 2 => "E. Verspyck" 3 => "H. Roman" 4 => "M. Scotté" 5 => "L. Marpeau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0301-2115(03)00086-1" "Revista" => array:6 [ "tituloSerie" => "Eur J Obstet Gynecol Reprod Biol" "fecha" => "2003" "volumen" => "110" "paginaInicial" => "107" "paginaFinal" => "110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12932884" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes of laparoscopic versus open colectomy in elective surgery for diverticulitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Masoomi" 1 => "B. Buchberg" 2 => "B. Nguyen" 3 => "V. Tung" 4 => "M.J. Stamos" 5 => "S. Mills" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00268-011-1117-4" "Revista" => array:6 [ "tituloSerie" => "World J Surg" "fecha" => "2011" "volumen" => "35" "paginaInicial" => "2143" "paginaFinal" => "2148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21732208" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735077/0000009900000007/v2_202109080639/S2173507721001654/v2_202109080639/en/main.assets" "Apartado" => array:4 [ "identificador" => "15076" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735077/0000009900000007/v2_202109080639/S2173507721001654/v2_202109080639/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173507721001654?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 0 | 4 |
| 2024 October | 21 | 4 | 25 |
| 2024 September | 50 | 13 | 63 |
| 2024 August | 27 | 8 | 35 |
| 2024 July | 39 | 4 | 43 |
| 2024 June | 24 | 6 | 30 |
| 2024 May | 30 | 6 | 36 |
| 2024 April | 38 | 7 | 45 |
| 2024 March | 44 | 4 | 48 |
| 2024 February | 42 | 2 | 44 |
| 2024 January | 53 | 6 | 59 |
| 2023 December | 63 | 2 | 65 |
| 2023 November | 47 | 7 | 54 |
| 2023 October | 81 | 4 | 85 |
| 2023 September | 38 | 3 | 41 |
| 2023 August | 41 | 1 | 42 |
| 2023 July | 47 | 3 | 50 |
| 2023 June | 67 | 0 | 67 |
| 2023 May | 79 | 2 | 81 |
| 2023 April | 72 | 2 | 74 |
| 2023 March | 70 | 2 | 72 |
| 2023 February | 48 | 3 | 51 |
| 2023 January | 48 | 8 | 56 |
| 2022 December | 34 | 2 | 36 |
| 2022 November | 25 | 8 | 33 |
| 2022 October | 12 | 6 | 18 |
| 2022 September | 14 | 16 | 30 |
| 2022 August | 11 | 8 | 19 |
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