Our Summary

This research paper discusses the case of a 74-year-old woman who was successfully treated for a colouterine fistula, a rare condition where an abnormal connection develops between the colon and the uterus. She had symptoms like lower abdominal discomfort and vaginal discharge with traces of feces. The woman was diagnosed with sigmoid colon diverticulitis, a condition where pouches within the wall of the colon become inflamed. After two weeks of non-surgical treatment, her symptoms improved and her blood tests showed signs of reduced inflammation. However, the issue of fecal contamination in her vaginal discharge persisted. The woman then underwent a laparoscopic surgery, a minimally invasive procedure, where her sigmoid colon and uterus were removed. Her health has been good three years post-surgery. The study suggests that laparoscopic surgery could be a suitable treatment option for patients with this condition if the inflammation is well-controlled and localized.

FAQs

  1. What is a colouterine fistula and what symptoms did the patient experience?
  2. How was the patient’s condition diagnosed and initially treated?
  3. What surgical procedure did the patient undergo, and what was the outcome of the treatment?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully, including proper wound care, pain management, and dietary guidelines to support healing and prevent complications. It is also important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support recovery and overall well-being after sigmoidectomy surgery.

Suitable For

Patients who may be recommended sigmoidectomy include those with:

  1. Severe diverticulitis: Sigmoidectomy may be recommended for patients with severe or recurrent diverticulitis, where the inflamed diverticula (pouches) in the colon are causing significant symptoms such as abdominal pain, bloating, and changes in bowel habits.

  2. Colouterine fistula: Patients with a rare condition like colouterine fistula, where there is an abnormal connection between the colon and the uterus, may require sigmoidectomy to remove the affected portion of the colon and prevent further complications.

  3. Colon cancer: Patients with colon cancer located in the sigmoid colon may undergo sigmoidectomy as part of their treatment plan to remove the tumor and surrounding tissue to prevent the spread of cancer.

  4. Inflammatory bowel disease: Patients with inflammatory bowel diseases such as ulcerative colitis or Crohn’s disease that primarily affect the sigmoid colon may require sigmoidectomy if medical treatment is not effective in controlling symptoms or complications such as strictures, fistulas, or abscesses.

  5. Chronic constipation: In some cases of severe chronic constipation that do not respond to conservative treatments, sigmoidectomy may be recommended to remove a portion of the colon that is causing the obstruction and improve bowel function.

Overall, the decision to recommend sigmoidectomy for a patient will depend on their specific condition, symptoms, and response to other treatments. It is important for patients to discuss the risks and benefits of surgery with their healthcare provider to make an informed decision about their treatment options.

Timeline

  • Before sigmoidectomy:
  1. Patient experiences lower abdominal discomfort and vaginal discharge with traces of feces.
  2. Patient is diagnosed with sigmoid colon diverticulitis.
  3. Patient undergoes two weeks of non-surgical treatment to reduce inflammation.
  4. Symptoms improve but issue of fecal contamination in vaginal discharge persists.
  • After sigmoidectomy:
  1. Patient undergoes laparoscopic surgery to remove sigmoid colon and uterus.
  2. Patient’s health improves post-surgery.
  3. Patient’s health remains good three years post-surgery.

What to Ask Your Doctor

  1. What is a sigmoidectomy and why is it recommended for my condition?
  2. What are the potential risks and complications associated with a sigmoidectomy?
  3. What is the recovery process like after a sigmoidectomy?
  4. Will I need to make any changes to my diet or lifestyle after the surgery?
  5. How long will it take for me to fully recover and resume normal activities?
  6. Are there any alternative treatment options available for my condition?
  7. How successful is laparoscopic surgery compared to traditional open surgery for a sigmoidectomy?
  8. Will I need any additional tests or procedures before the surgery?
  9. What are the long-term outcomes and potential benefits of undergoing a sigmoidectomy for my condition?
  10. Are there any specific warning signs or symptoms I should watch out for after the surgery?

Reference

Authors: Arakawa S, Morise Z, Isetani M, Tomishige H, Kawabe N, Nagata H, Asano Y, Kawase J, Kamio K, Imaeda Y, Umemoto S, Ikeda M, Horiguchi A. Journal: Asian J Endosc Surg. 2017 Nov;10(4):415-419. doi: 10.1111/ases.12378. Epub 2017 May 29. PMID: 28557372