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Colouterine fistula complicating diverticulitis: charcoal challenge test aids in diagnosis.
Obstet Gynecol. 1992 Sep; 80(3 Pt 2):550-2.OG

Abstract

Fistula formation between a segment of colon and the uterus is an unusual complication of diverticulitis; only 17 cases have been reported in the world literature. We describe a 69-year-old woman with a colouterine fistula secondary to diverticulitis. She presented with a malodorous vaginal discharge that grew multiple enteric organisms on culture. A barium enema revealed colonic diverticula but no fistula tract. Orally administered activated charcoal was seen flowing from the cervical os during a pelvic examination the following day, establishing a diagnosis of colouterine fistula. Pathologic examination of the resected colon and uterus confirmed this diagnosis and determined that diverticulitis was the etiology. From a review of the literature, we conclude that radiographic and invasive procedures cannot be depended upon for diagnosis. Ingestion of activated charcoal may provide a simple, noninvasive approach to the diagnosis of enterouterine fistulas.

Authors+Show Affiliations

Huettner PC
Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Finkler NJ
No affiliation info available
Welch WR
No affiliation info available

MeSH

AgedCharcoalColonic DiseasesDiverticulitis, ColonicFemaleFistulaHumansIntestinal FistulaUterine Diseases

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

1365699

Citation

Huettner, P C., et al. "Colouterine Fistula Complicating Diverticulitis: Charcoal Challenge Test Aids in Diagnosis." Obstetrics and Gynecology, vol. 80, no. 3 Pt 2, 1992, pp. 550-2.
Huettner PC, Finkler NJ, Welch WR. Colouterine fistula complicating diverticulitis: charcoal challenge test aids in diagnosis. Obstet Gynecol. 1992;80(3 Pt 2):550-2.
Huettner, P. C., Finkler, N. J., & Welch, W. R. (1992). Colouterine fistula complicating diverticulitis: charcoal challenge test aids in diagnosis. Obstetrics and Gynecology, 80(3 Pt 2), 550-2.
Huettner PC, Finkler NJ, Welch WR. Colouterine Fistula Complicating Diverticulitis: Charcoal Challenge Test Aids in Diagnosis. Obstet Gynecol. 1992;80(3 Pt 2):550-2. PubMed PMID: 1365699.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colouterine fistula complicating diverticulitis: charcoal challenge test aids in diagnosis. AU - Huettner,P C, AU - Finkler,N J, AU - Welch,W R, PY - 1992/9/1/pubmed PY - 1992/9/1/medline PY - 1992/9/1/entrez SP - 550 EP - 2 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 80 IS - 3 Pt 2 N2 - Fistula formation between a segment of colon and the uterus is an unusual complication of diverticulitis; only 17 cases have been reported in the world literature. We describe a 69-year-old woman with a colouterine fistula secondary to diverticulitis. She presented with a malodorous vaginal discharge that grew multiple enteric organisms on culture. A barium enema revealed colonic diverticula but no fistula tract. Orally administered activated charcoal was seen flowing from the cervical os during a pelvic examination the following day, establishing a diagnosis of colouterine fistula. Pathologic examination of the resected colon and uterus confirmed this diagnosis and determined that diverticulitis was the etiology. From a review of the literature, we conclude that radiographic and invasive procedures cannot be depended upon for diagnosis. Ingestion of activated charcoal may provide a simple, noninvasive approach to the diagnosis of enterouterine fistulas. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/1365699/Colouterine_fistula_complicating_diverticulitis:_charcoal_challenge_test_aids_in_diagnosis_ DB - PRIME DP - Unbound Medicine ER -