Sigmoidouterine Fistula Complicating Diverticulitis

In a recent case report and review of the literature, Franco and Clough1noted reports, including their own, of 75 cases of enterouterine fistula. These cases occurred following (1) carcinoma of either the intestine or uterus with subsequent invasion of the other structure and communication of the lumina, (2) rupture of the uterus (either spontaneous or produced during labor), or (3) inflammatory disease (such as pathological puerperium and appendicular abscess) causing peritonitis. Under this last heading, diverticulitis with abscess formation may be included. Only two cases of sigmoidouterine fistula complicating diverticulitis have been reported prior to the time of this writing, one by Noecker,2in 1929, and another by Johnston and Stubbs,3in 1955. The advised treatment consists of preliminary preparation of the patient with antibiotics, sterilization of the intestine, diet, and transfusions. Johnston and Stubbs felt that, in the absence of infection and obstruction, primary resection