Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

22 November 2018 : Case report  Greece

Sigmoido-Cecal Fistula: A Rare Case of Complicated Recurrent Diverticulitis and a Review of the Literature

Unusual clinical course, Management of emergency care

Titika-Marina Strati1ABCDEF*, Konstantinos Sapalidis1AD, Georgios D. Koimtzis1DE, Efstathios Pavlidis1AB, Stefanos Atmatzidis1AB, Lazaros Liavas1DEF, Ioannis Chrysogonidis2CD, Georgios Samoilis2CDE, Katerina Zarampouka3C, Kyriaki Michailidou1B, Isaac I. Kesisoglou1EF, Christoforos Kosmidis1ABCDEF

DOI: 10.12659/AJCR.911790

Am J Case Rep 2018; 19:1386-1392


BACKGROUND: Although diverticular disease is well described and treated in daily clinical practice, there are cases that attract great interest because of their complexity and difficulty in management. Herein, we describe a rare case of colo-colonic fistula-complicated diverticulitis that necessitated urgent surgical intervention.

CASE REPORT: A 76-year-old female patient with a known history of diverticular disease of the sigmoid colon presented in the Emergency Department for evaluation of left lower quadrant abdominal pain. The clinical and radiological examinations revealed a recurrent episode of acute diverticulitis of the sigmoid colon. However, it was of great interest that we detected a sigmoido-cecal fistula in the abdominal computed tomography (CT). The patient was admitted to the hospital for conservative treatment. After 48 hours, the patient’s clinical status deteriorated, with pain aggravation, abdominal distension, bloating, and metallic bowel sounds. The simple abdominal x-ray revealed large-bowel obstruction and the CT demonstrated worsening inflammation of the sigmoid colon. An exploratory laparotomy revealed an inflamed dolichol-sigmoid colon forming a fistulous tract with the cecum and thus, mimicking a closed loop obstruction. The sigmoid colon was transected en bloc with the sigmoido-cecal fistula and a Hartmann’s procedure was performed.

CONCLUSIONS: This case is extremely unusual as the patient presented at the same time two complications of diverticular disease, both obstruction and this rare formation of sigmoido-cecal fistula. It is presented in order to acquaint surgeons with the possibility of an unexpected course of this disease which indeed necessitates an individualized management.

Keywords: Cecum, Digestive System Fistula, Diverticulitis, Colonic, Intestinal Fistula, Sigmoid Diseases

Add Comment 0 Comments

1176 16

In Press

20 Sep 2023 : Case report  Switzerland

A Red, Swollen, and Warm Foot in a Kidney–Pancreas-Transplanted Type 1 Diabetic Patient: Is It Always Charc...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939071  

18 Sep 2023 : Case report  USA

Life-Threatening Aortic Dissection during Pregnancy: A Case Report of Undiagnosed FBN1-Related Marfan Syndr...

Am J Case Rep In Press; DOI: 10.12659/AJCR.940628  

18 Sep 2023 : Case report  Japan

A Lethal Combination: Legionnaires’ Disease Complicated by Rhabdomyolysis, Acute Kidney Injury, and Non-Occ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.940792  

18 Sep 2023 : Case report  USA

Vasovagal Pre-Syncope Induced by Epidural Electrical Stimulation Test: A Rare Case Report in a 61-Year-Old ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.941004  

Most Viewed Current Articles

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

07 Dec 2021 : Case report  USA

Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Fac...

DOI :10.12659/AJCR.934347

Am J Case Rep 2021; 22:e934347

13 Jul 2022 : Case report  USA

Whistling Scrotum: An Unusual Presentation of Pneumomediastinum in the Setting of an Open Scrotal Wound

DOI :10.12659/AJCR.936441

Am J Case Rep 2022; 23:e936441

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923