Colouterine fistula secondary to endometriosis with associated chorioamnionitis.
BACKGROUND
Intestinal endometriosis may be complicated by bowel obstruction, colonic rupture, sepsis, and rarely, malignant transformation. Fistula formation is extremely rare.


METHODS
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.


CONCLUSIONS
This case illustrates a rare complication of colouterine fistula secondary to intestinal endometriosis.
Sriganeshan
Vathany
V
Arkadi M. Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA. vathanysri@yahoo.com
Willis
Irvin H
IH
Zarate
Luis A
LA
Howard
Lydia
L
Robinson
Morton J
MJ
D000328:Adult; D002429:Cecal Diseases / Q000150:complications*; D002821:Chorioamnionitis; D003108:Colonic Diseases / Q000209:etiology*; D004715:Endometriosis / Q000150:complications*; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D011247:Pregnancy; D014591:Uterine Diseases / Q000209:etiology*