Colouterine fistula secondary to pyometra: a case report

Abstract

Colouterine fistula secondary to pyometra: a case report Moon Kyoung Cho1 , Tae Young Kim1 , Chul Hong Kim1, * 1Department of Obstetrics and Gynecology, Chonnam National University Medical School, 61469 Gwangju, Korea *Correspondence: hongkim@chonnam.ac.kr (Chul Hong Kim) DOI:10.31083/j.ceog.2021.02.2306 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 25 September 2020 Revised: 10 December 2020 Accepted: 23 December 2020 Published: 15 April 2021 Pyometra is defined as the collection of purulent material in the uterine cavity. Colouterine fistula is a rare condition with less than 30 cases being reported in the literature. We believe this to be the first reported case of colouterine fistula secondary to pyometra. An 85-year-old woman with generalized abdominal pain and malodorous vaginal discharge for two weeks presented to the emergency room of Chonnam national university hospital. Physical examination confirmed the presence of the malodorous vaginal discharge. Abdominopelvic computed tomography scan demonstrated an abscess within the endometrial cavity and the presence of a fistula betweenthecolonandtheuterus. Thepatientunderwentmagneticresonance imaging which revealed a communication between the distal sigmoid colon and the uterus. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, drainage of the abscess and a sigmoid colon resection were performed. Histopathological study of the surgical specimen revealed acute suppurative inȠlammation without evidence of malignancy. Keywords Pyometra; Fistula; Abdominal pain