Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Online ISSN : 1882-5133
Print ISSN : 1345-2843
ISSN-L : 1345-2843
A CASE OF MULTIPLE DIVERTICULOSIS OF THE SMALL INTESTINE WITH ENTEROVAGINAL FISTULIZATION DUE TO DIVERTICULITIS
Seiji ISHIGUROShigeaki MORIURAIchiro KOBAYASHITomotake TABATATakatoshi MATSUMOTOTaichiro SATO
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2002 Volume 63 Issue 1 Pages 113-116

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Abstract
A 72-year-old woman was seen at the hospital because of fecal like vaginal flour. There was a small opening 1mm in size at the surgical stump of vagina after a hysterectomy, from which discharge was observed. Fistulography visualized the small intestine. Enterovaginal fistula was diagnosed and a laparotomy was performed. During surgery, the ileum 15cm distal to the Bauhun valve formed a fistula with the vaginal stump. Associated resection of the ileum by 10cm in length with the vaginal stump was performed. Over 100 diverticula were present in the entire small intestine from the Treitz ligament and enterovaginal fistula due to deverticulitis was diagnosed. Diverticulosis is commonly found in the large intestine, but rarely in the small intestine. Of small vowel diverticula, congenital Meckel diverticulum is the most common. Diverticula of the small intestine are acquired false diverticula, and most of them are localized in the duodenum. Those arising in the jejunum and ileum are rare. This paper presents the case of enterovaginal fistula due to diverticulitis in which more than 100 diffused diverticula in the jejunum and ileum were seen at the operation, together with some bibliographical comments about small bowel diverticulosis.
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