title: Appendiceal-sigmoid fistula presenting in a man with ulcerative colitis: a case report.
abstract: BACKGROUND
  Ulcerative colitis is a chronic disease characterized by diffuse mucosal inflammation limited to the colon. It mostly affects young adults, yet a large number of middle-aged and older patients with ulcerative colitis have also been reported.
  
  
  METHODS
  A 58-year-old Caucasian man presented to our hospital in August 2006 with continuous and diffuse abdominal pain, meteorism, fever and bloody diarrhea. He had a two-year history of ulcerative colitis. Our patient was treated with intravenous medical therapy. As his condition worsened, he underwent surgery. An explorative laparotomy revealed that the entire colon was distended and pus was found around an appendiceal-sigmoid fistula.
  
  
  CONCLUSIONS
  Therapy for ulcerative colitis is a rapidly evolving field, with many new biological agents under investigation that are likely to change therapeutic strategies radically in the next decade. Indications for surgery are intractability (49%), stricture, dysplasia, toxic colitis, hemorrhage and perforation. To the best of our knowledge, this is the first case of an appendiceal-sigmoid fistula in a patient affected by ulcerative colitis reported in the literature. Fistulae between the appendix and the sigmoid tract are rarely reported in cases of diverticular disease and appendicitis.
authors.affiliation: Department of Surgical Sciences, Organ Transplantations and Advanced Technologies, University of Catania, Via Santa Sofia, 95123 Catania, Italy. zoster@interfree.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Santangelo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Lanteri
authors.forename: Maria
authors.initials: M
authors.lastname: D'Angelo
authors.forename: Santo A
authors.initials: SA
authors.lastname: Carnazzo
authors.forename: Agostino
authors.initials: A
authors.lastname: Ragalbuto
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Minutolo
authors.forename: Antonio
authors.initials: A
authors.lastname: Licata