title: Penetration of the sigmoid colon to the posterior uterine wall secondary to diverticulitis: a case report.
abstract: BACKGROUND
  Penetration of the colon to the posterior uterine wall secondary to diverticulitis is unusual, with diagnostic methods not yet established. Non-invasive imaging, such as computed tomography and magnetic resonance imaging may help to establish a proper diagnosis, but confirmation may be reached only after surgical exploration.
  
  
  METHODS
  We report the case of a 78-year-old Japanese woman who presented with a low grade fever and mild diarrhea which occurred two or three times a week. Computed tomography and magnetic resonance imaging demonstrated a capsular lesion including an air structure with a diameter of 5 cm, between the posterior aspect of the uterine body and the sigmoid colon. A gastrograffin enema and colonoscopy demonstrated a giant diverticulum of the sigmoid colon with no evidence of malignancy. These data confirmed the diagnosis of diverticulitis complicated by a giant diverticulum. Because of a relapsing fever after therapy with antibiotics, the patient had en bloc surgical treatment of the uterus, fallopian tubes, ovaries and sigmoid colon, the organs involved in the diverticulitis, followed by an uneventful recovery.
  
  
  CONCLUSIONS
  This is a rare case report of penetration of the sigmoid colon to the posterior uterine wall secondary to diverticulitis.
authors: Gastroenterology Division, Yokohama City University Hospital, Yokohama, Japan. t066002g@yokohama-cu.ac.jp.
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