Case Report Colouterine and Jejunouterine Fistula Secondary to Chronic Diverticulitis Ilias Galanis , Georgios Floros , Christophoros Theodoropoulos, Myriam Metaxa, Panagiotis Theodoropoulos, Panagiotis Tsintavis, Dimitrios Bartziotas, Georgios Giannos, Georgios Stylianidis, and Georgios Papadopoulos Department of Surgery, Evaggelismos General Hospital, Athens, Greece Correspondence should be addressed to Ilias Galanis; iliasg100@gmail.com Received 11 February 2021; Revised 22 March 2021; Accepted 26 March 2021; Published 1 April 2021 Academic Editor: Hirotada Akiho Copyright©2021IliasGalanisetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Fistulaebetweenthecolonorthesmallintestineandtheuterusareextremelyrareastheuterusisathick,muscularorgan.Here,we presentthecaseofa74-year-oldfemalepresentingtooursurgicaldepartmentbecauseoffecalvaginaldischargeforthepastfew months, which proved to be caused by a combined colouterine and jejunouterine fistula due to chronic diverticulitis. Total abdominal hysterectomy with bilateral oophorectomy with en bloc resection of part of the jejunum and the sigmoid colon and primary anastomoses were performed. is case represents an unusual type of diverticulitis complication and aims to point out the diagnostic and therapeutic issues of such a rare medical condition. 1.Introduction Diverticulosis is one of the most common colonic pathol- ogies. It affects, mostly, those who are living in developed countries, and its incidence is well known to increase with age. However, the incidence of diverticular disease has, recently, been increasing in ird-World countries [1]. Diverticulitis is the result of infection and inflammation of diverticula. e complications of diverticulitis are stricture, bleeding, perforation, fistula formation, and death [2]. Fistulisation is defined as a communication between two surfacesgettingincontact[3].Fistulaeconstituteupto20% ofcomplications.eformationofthefistularesultsfroma local inflammatory process which decompresses by perfo- rating into an adjacent tissue. e most common type of fistulae due to diverticulitis is colovesical fistulae, with colovaginal fistulae being the second most common. Colouterine, as well as jejunouterine, fistulae are very rare because the uterus is a very thick and muscular organ, preventinganybenignormalignantdiseasefrominvadingit [4].Exceptfordiverticulitis,malignantdisease,spontaneous rupture of a gravid uterus, and obstetric trauma such as curettage and radiation therapy may result in a fistula be- tween the intestine and the uterus [5]. A colouterine fistula was,first,describedbyLejemtelin1909,andthefirstreport ofthecolouterinefistularelatedtodiverticulitiswasgivenby Noecker in 1929 [1]. Since then, only very few cases have been reported in the literature, indicating the rarity of this condition. 2.Case A 74-year-old female was referred to our department of surgery with malodorous fecal vaginal discharge that had lasted several weeks. Medical history included multiple episodes of acute diverticulitis and dementia. She had no abdominal pain or fever. Upon admission, her laboratory tests were within the normal range. Pelvic examination revealed an atrophied vagina and malodorous yellowish vaginal discharge. A colovaginal fistula, secondary to di- verticular disease, was suspected as it is the most common type of fistula between the gastrointestinal and female re- productive system. Cultures of the vaginal discharge were sent. Nil per os, total parenteral nutrition, and intravenous Hindawi Case Reports in Gastrointestinal Medicine Volume 2021, Article ID 5543505, 3 pages https://doi.org/10.1155/2021/5543505