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Colouterine Fistula Secondary to Endometriosis With Associated Chorioamnionitis

Sriganeshan, Vathany MD1; Willis, Irvin H. MD1; Zarate, Luis A. MD1; Howard, Lydia MD1; Robinson, Morton J. MD1

doi: 10.1097/01.AOG.0000168443.22820.2e
Case Report
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BACKGROUND: Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare.

CASE: A 26-year-old woman presented at 16 weeks of gestation with an acute abdomen suggestive of ruptured appendicitis. Blood cultures were positive for Bacteroides fragilis. At laparotomy, she was found to have a colouterine fistula with pelvic sepsis. The resected specimens demonstrated extensive uterine adenomyosis and endometriosis of the cecum, with a fistulous tract lined by endometriosis and suppurative inflammation extending from the cecum to the uterine endometrial cavity associated with severe chorioamnionitis and endomyometritis.

CONCLUSION: This case illustrates a rare complication of colouterine fistula secondary to intestinal endometriosis.

We report a patient with a unique complication of pregnancy secondary to a colouterine fistula in an area of endometriosis with associated acute chorioamnionitis.

1From the Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Florida.

Corresponding author: Vathany Sriganeshan, MD, Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, 4300 Alton Road, Blum Building, Room 201, Miami Beach, FL 33140; e-mail: vathanysri@yahoo.com.

© 2006 The American College of Obstetricians and Gynecologists