Current indications and role of surgery in the management of sigmoid diverticulitis

Figure 2 Fistula. A: Colovesical fistula as indicated by the presence of air in the bladder. This patient had symptoms and other CT findings consistent with sigmoid diverticulitis; B: Sigmoid diverticulitis and colovaginal fistula. This patient had undergone previous hysterectomy and complained of feculent discharge from her vagina. CT scan indicated inflamed sigmoid with adherent small bowel loop (arrow). The small bowel loop could be successfully separated from the sigmoid at the time of laparoscopic sigmoidectomy. There was no evidence of coloenteric fistula; Sigmoid diverticulitis with colocutaneous fistula (arrows) (C and D) (courtesy of Dr. Ravi Pokala Kiran, Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA).