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.

Post-LSCS uterocutaneous fistula-utility of magnetic resonance imaging in its diagnosis

“…The various modalities that can be used in the diagnosis of uterocutaneous fistula include fistulography with injection of contrast through the skin site, hysterosalpingography with injection of contrast via cervix, computed tomography (CT) scanning, and MRI. Fistulography and hysterosalpingography define the fistulous tract but cannot provide details of its communication with the other intra-abdominal viscera (1,3) . CT imaging helps in the proper delineation of the tract after the injection of the contrast agent through the abdominal site, but soft tissue resolution of CT scans is less compared with MRI (10,11) .…”

“…Uterine fistulae usually occur between the uterus and bowel or bladder (uterocolic or uterovesical) with uterocutaneous forming the rarest variety of uterine fistulae. The fistulae occur due to postoperative injuries or infections, use of drains, and incomplete closure of incision (1) . Uterocutaneous fistulae, being a rare condition, need appropriate diagnosis for which magnetic resonance imaging (MRI) plays the most important role, thereby helping in the proper delineation of the tract to guide the appropriate management (2) .…”

A case report of a colouterine fistula treatment: when the patient chooses the steeplechase

“…Colouterine fistula is an extremely rare disease [ 1 – 4 ], the treatment of which can be challenging [ 5 , 6 ]. There are many possible causes of the disease, including uterine iatrogenic trauma, inflammation with abscess, uterine or sigmoidal carcinoma, and radiotherapy complications [ 1 ].…”

“…Colouterine fistula is an extremely rare disease [ 1 – 4 ], the treatment of which can be challenging [ 5 , 6 ]. There are many possible causes of the disease, including uterine iatrogenic trauma, inflammation with abscess, uterine or sigmoidal carcinoma, and radiotherapy complications [ 1 ]. Diverticular disease (DD), complicated with diverticulitis through the rupture of a diverticulum or abscess into an adjacent organ, could be another cause [ 2 ].…”

Colouterine and Jejunouterine Fistula Secondary to Chronic Diverticulitis

“…The most common type of fistulae due to diverticulitis is colovesical fistulae, with colovaginal fistulae being the second most common. Colouterine, as well as jejunouterine, fistulae are very rare because the uterus is a very thick and muscular organ, preventing any benign or malignant disease from invading it [ 4 ]. Except for diverticulitis, malignant disease, spontaneous rupture of a gravid uterus, and obstetric trauma such as curettage and radiation therapy may result in a fistula between the intestine and the uterus [ 5 ].…”