A case of sigmoid-vaginal fistula treated by laparoscopic surgery

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  • 瘻孔の同定に難渋した結腸腟瘻に対し腹腔鏡下手術を行った1例
  • 症例報告 瘻孔の同定に難渋した結腸腟瘻に対し腹腔鏡下手術を行った1例
  • ショウレイ ホウコク ロウコウ ノ ドウテイ ニ ナンジュウ シタ ケッチョウチツロウ ニ タイシ フククウキョウ シタテジュツ オ オコナッタ 1レイ

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Abstract

<p>A 53-year-old woman, G4P1 (three artificial abortions, including 1 mid-term abortion), who had a past history of diverticulitis that was treated conservatively, visited our hospital presenting stool-like discharge. Colonoscopy revealed diverticulitis of the sigmoid colon, and a fistula extending from the sigmoid colon to the lower uterus or vagina was found on barium enema examination. From these findings, she was diagnosed as sigmoid-vaginal fistula secondary to diverticulitis of the sigmoid colon, and laparoscopic hysterectomy and partial sigmoidectomy were performed. The fistula was located between the sigmoid colon and vaginal fornix, forming an adhered abscess. The postoperative course was uneventful and no recurrence has been reported. Sigmoid-vaginal fistula is rare and radical operation can be difficult because of inflammation or adhesion. However, laparoscopic surgery is possible for such inflammatory fistulas. This report presents the case with a discussion of previous reports. [Adv Obstet Gynecol, 72 (1) : 40-45, 2020 (R2.2)]</p>

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