Colouterine fistula secondary to endometriosis with associated chorioamnionitis.

Abstract

Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare. 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. This case illustrates a rare complication of colouterine fistula secondary to intestinal endometriosis.