title: Early diagnosis of a diverticular colovaginal fistula with colposcopy. A case report.
abstract: Seventy cases of colovaginal fistula complicating diverticular disease are documented in the literature. Predisposing factors are advanced age and previous hysterectomy. We diagnosed a case early on with careful colposcopic observation of the volcanic ejection of pus from multiple sites in the vaginal apex; we propose naming that phenomenon the "Io" sign after the most eruptive celestial body known. We also documented the association of a coloovarian fistula, ureteral obstruction and endometriosis with this disease process. Considering the expected growth in the geriatric population and the frequency of hysterectomy, clinicians should familiarize themselves with this life-threatening illness.
authors.affiliation: Department of Obstetrics and Gynecology, Pennsylvania Hospital, Philadelphia.
authors.forename: P M
authors.initials: PM
authors.lastname: Wisniewski
authors.forename: T
authors.initials: T
authors.lastname: Coonrod
authors.forename: M A
authors.initials: MA
authors.lastname: Thonet
authors.forename: A S
authors.initials: AS
authors.lastname: Horn
mesh_terms: D000368:Aged; D001706:Biopsy; D003108:Colonic Diseases / Q000473:pathology* / Q000601:surgery; D003127:Colposcopy; D004239:Diverticulitis, Colonic / Q000473:pathology*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D007412:Intestinal Fistula / Q000473:pathology* / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology; D014621:Vagina / Q000473:pathology; D014624:Vaginal Fistula / Q000473:pathology* / Q000601:surgery