title: [Sigmoido-buttock fistula by diverticulitis: report of a rare complication].
abstract: BACKGROUND
  The complicated diverticulitis of the colon is characterized by its association with abscesses, bleeding, stenosis, perforation, obstruction or fistula. We report a case of spontaneous sigmoido-cutaneous fistula from diverticulitis to an unusual place in the gluteal region.
  
  
  METHODS
  A 59-year-old male patient presented an inflammatory wound in left buttock without response to the conservative medical treatment. The fistulography, colonoscopy, barium enema and computed tomography showed a sigmoido-cutaneous fistula to the left buttock from diverticulitis. The biopsy of the lesion ruled out malignancy. We performed an elective sigmoid resection with primary colorectal anastomosis, partial fistulectomy and injection of a fibrin sealant in the residual tract.
  
  
  CONCLUSIONS
  The colon-cutaneous fistulas from diverticulitis are relatively rare. We report a spontaneous fistula with origin in a single diverticulum in the sigmoid colon and that drained through the piriform fossa of the pelvic floor to the skin of the left buttock.
  
  
  CONCLUSIONS
  A high index of suspiscion is necessary to not confuse the colo-buttock fistula with local abscesses.
authors.affiliation: Departamento de Cirugía General, Hospital Regional "Dr. Valentín Gómez Farías," Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Zapopan, Jalisco, México. gevaristo5@yahoo.com.mx
authors.forename: Gerardo
authors.initials: G
authors.lastname: Evaristo-Méndez
authors.forename: Alma Teresa
authors.initials: AT
authors.lastname: Sánchez-Hernández
authors.forename: Armando
authors.initials: A
authors.lastname: Melo-Velázquez
authors.forename: Félix Antonio
authors.initials: FA
authors.lastname: Ventura-Sauceda
authors.forename: Rogelio Ricardo
authors.initials: RR
authors.lastname: Sepúlveda-Castro
mesh_terms: D000368:Aged; D000686:Amyloidosis / Q000150:complications; D000714:Anastomosis, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003113:Colonoscopy; D003131:Combined Modality Therapy; D003475:Curettage; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D004238:Diverticulitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004322:Drainage; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000209:etiology; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D015718:Fibrin Tissue Adhesive
keywords: colo-cutaneous fistula; diverticulitis