Colo-ovarian fistula masquerading as tubo-ovarian abscess: a case report
Abstract
Background Colo-ovarian fistulas are exceptionally rare complications of diverticulitis, with very few cases documented. Their nonspecific presentation often mimics gynecologic pathology, frequently leading to misdiagnosis and delayed treatment. Currently, there are no standardized guidelines for diagnosis or management of colo-ovarian fistulas. This unique case describes a patient who initially presented with findings suggestive of a tubo-ovarian abscess (TOA), but contrast-enhanced computed tomography (CT) with oral and rectal contrast revealed a colo-ovarian fistula, illustrating a potential diagnostic pathway for this rare condition. Case Description A 36-year-old woman with no significant medical history presented with left lower quadrant abdominal pain. Initial evaluation at an outside facility suggested a TOA and empiric antibiotics were initiated. Upon transfer, contrast-enhanced CT with oral and rectal contrast revealed a 6.8 cm left adnexal fluid collection containing air, with a fistulous tract connecting the sigmoid colon to the left ovary. Percutaneous drainage was deemed unsafe due to the posterior location of the lesion and surrounding bowel. She underwent robotic-assisted sigmoid colectomy with primary anastomosis and left salpingo-oophorectomy. Intraoperative findings confirmed dense adhesions and purulent material within the ovary. Pathology revealed diverticulitis with colonic perforation and an ovarian abscess containing digested food, confirming…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.