부산대학교 도서관

A 79-year-old woman who had undergone total hysterectomy for a uterine leiomyoma 40 years earlier visited our hospital. Perianal pain and fever were observed, and symptoms were relieved by treatment such as antibiotic administration, but the leakage of stool from the vagina appeared. Upon vaginaloscopy examination, a fistula was observed on the right side of the vaginal cut end, which was diagnosed as colovaginal fistula. Digital examination and anoscopic examination showed no obvious abnormality, but sigmoid colon was observed by contrast examination from the vagina.A diagnosis of sigmoid colovaginal fistula was made and surgical operation was performed. The sigmoid colon showed remarkable wall thickening and the fistula communicated with the abscess cavity. Closure of the vaginal stump and sigmoidectomy were performed and ileostomy construction was performed. An ileostomy closure was done 4 months after surgery, after which recurrence was not recognized. In this case it was considered that the pelvic abscess caused by sigmoid colon diverticulitis drained into the vaginal cavity from the fragile vaginal stump and then formed the sigmoid colovaginal fistula.