2017, Number 2
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ABSTRACTIntroduction: Fistula is an abnormal passageway between two epithelium organs in the body that normally do not connect or between an organ and the exterior of the body. Spontaneous colo-umbilical fistulas secondary to non-complicated diverticular disease are rare. The aim of this paper is to report the second case of spontaneous colo-umbilical fistula. Case report: The following case report describes the development of a colo-umbilical fistula in a 56-year-old male patient that manifested with the outflow of intestinal material through the umbilical scar; once colonoscopy was completed, it showed non complicated diverticular disease. The patient did not show any symptoms; therefore, an exploratory laparotomy was performed, finding sigmoid colon communication to the umbilical scar. Results: We performed a sigmoidectomy with transverse-recto anastomosis; the patient recovered properly and left the surgery service three days after the surgical procedure. Discussion: There are different causes of fistula; one of them is diverticular disease, followed by others like inflammatory bowel disease —in particular, Crohn disease— and injury to the urinary tract. Conclusion: The most common cause of fistulas in Mexico is complicated diverticular disease or diverticulitis. The first case report of colo-umbilical fistula was reported in 1993. This is the second case reported.
Pracyk JB, Pollard SG, Calne RY. The development of spontaneous colo-umbilical fistula. Postgrad Med J. 1993; 69: 750-751.
Horner JL. Natural history of diverticulosis of the colon. Am J Dig Dis. 1958; 3: 343-350.
Larson DM, Masters SS, Spiro HM. Medical and surgical therapy in diverticular disease: a comparative study. Gastroenterology. 1976; 71:734-737.
Cheadle WG, Garr EE, Richardson JD. The importance of early diagnosis of small bowel obstruction. Am Surg. 1988; 54: 565-569.
Köhler L, Sauerland S, Neugebauer E. Diagnosis and treatment of diverticular disease: results of a consensus development conference. The Scientific Committee of the European Association for Endoscopic Surgery. Surg Endosc. 1999; 13: 430-436.
Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg 2000; 180: 33-36.
Mucha P Jr. Small intestinal obstruction. Surg Clin North Am. 1987; 67: 597-620.
Vane DW, West KW, Grosfeld JL. Vitelline duct anomalies. Experience with 217 childhood cases. Arch Surg. 1987; 122: 542-547.
Moore TC. Omphalomesenteric duct malformations. Semin Pediatr Surg. 1996; 5: 116-123.
Roberts P, Abel M, Rosen L, Cirocco W, Fleshman J, Leff E, et al. Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons. Dis Colon Rectum. 1995; 38: 125-132.
Benn PL, Wolff BG, Ilstrup DM. Level of anastomosis and recurrent colonic diverticulitis. Am J Surg. 1986; 151: 269-271.