Ureterocolic Fistula Secondary to Colonic Diverticulitis

Abstract

We describe the case of a 45-year-old woman with a ureterocolic fistula caused by colonic diverticulitis. She had a 10-year history of intermittent left flank pain that had not been treated. The fistulous tract between the left ureter and sigmoid colon was confirmed by retrograde urography and a barium enema. A nephroureterectomy was successfully performed.

Coloseminal Vesicle Fistula: Report of a Case and Review of the Literature

“…2 Other uncommon fistulas from diverticulitis have been identified, such as colouterine, 3 colosalpingeal, 4 and ureterocolic. 5 We present the first reported case of a fistula between the sigmoid colon and the seminal vesicle in a patient with diverticulitis. Our case demonstrates the potential for fistulous communication between the sigmoid colon and an accessory sex organ.…”

A case with fistula formation between a perinephric retroperitoneal abscess, a ureter and a descending colon: Successful outcome after conservative management

“…[1][2][3][4][5] The most common causes of spontaneous uretero-colic fistula are diverticulitis; causes for an obstructing ureter include ureteral calculi, tuberculosis, trauma, tumour and inflammatory bowel disease. 4 The suspected etiology in this case was that the impacted ureteral stone with urosepsis caused necrosis of the adjacent ureteral wall and the urosepsis inevitably perforated into an adjacent colon.…”

“…2 If the kidney is functioning, and the contralateral kidney has a reduced functional capacity, removal of the fistulous tract and reanastomosis of the ureter should be considered. 2 It has also been reported that adequate drainage and antibiotic therapy may lead to spontaneous closure of a uretero-colic fistula secondary to calcuous pyohydro- iwamoto and Kato ureteronephrosis. 4 Quantification of the degree of residual renal function within the affected kidney after relief of the obstruction is important to plan the definitive surgery.…”

Uretero‐appendiceal fistula

“…In cases of ureterocolic fistula, it has been recommended that nephrectomy with excision and closure of the fistula should be pursued if the affected kidney is non‐functioning. If the kidney is functioning, and the contralateral kidney has a reduced functional capacity, removal of the fistulous tract and reanastomosis of the ureter should be considered 5 . It has also been reported that adequate drainage and antibiotic therapy led to spontaneous closure of a ureterocolic fistula secondary to diverticulitis, and radical resection was not recommended in the acute stage 6 .…”

“…If the kidney is functioning, and the contralateral kidney has a reduced functional capacity, removal of the fistulous tract and reanastomosis of the ureter should be considered. 5 It has also been reported that adequate drainage and antibiotic therapy led to spontaneous closure of a ureterocolic fistula secondary to diverticulitis, and radical resection was not recommended in the acute stage. 6 The four reported cases of uretero-appendiceal fistula were managed by appendectomy with distal ureterectomy 1,3,4 (in these three cases, nephrectomy had been carried out before this surgery), or appendectomy with a Boari flap for the anastomosis of ureter and bladder.…”