Spontaneous Colo-Umbilical Fistula Complicating Diverticulitis of the Sigmoid Colon

Abstract

Colocutaneous fistula caused by diverticulitis is relatively uncommon with colo-umbilical fistulas being even rarer. We herein report a rare case of a spontaneous colo-umbilical fistula due to diverticulitis of the sigmoid colon. The fistula developed from a diverticulum of the sigmoid colon that discharged through the umbilicus after two episodes of acute diverticulitis. The condition was successfully treated by resectional surgery.

Surgical management of colocutaneous fistulae in diverticulitis

“…Diverticulitis with fistulae are uncommon, present in ~20% of cases 3 . Fistulae usually form between structures adjacent to the inflamed bowel and can develop connections to many organs with ~33%–69% being colovesical, 25% colovaginal, 6% coloenteric and 5%–6% colocutaneous 4–6 …”

“…3 Fistulae usually form between structures adjacent to the inflamed bowel and can develop connections to many organs with ~33%-69% being colovesical, 25% colovaginal, 6% coloenteric and 5%-6% colocutaneous. [4][5][6] The diagnosis of diverticulitis in this patient was challenging given the clinical history suggestive of a bowel obstruction rather than diverticulitis. Preoperative imaging could have facilitated surgical planning and locate any infective collections.…”