A CASE OF ABDOMINAL AORTIC ANEURYSM COMPLICATED BY PERFORATED SIGMOID COLON DIVERTICULITIS

Abstract

A 64-year-old man was admitted to another hospital because of weight loss and constipation. He was diagnosed as perforated sigmoid colon diverticulitis with abscess formation and an incidental abdominal aortic aneurysm (AAA). After four-month medical treatment of the abscess, he was referred to our institution for the treatment of AAA. Since the patient was asymptomatic and the abscess was apparently contained and inactive, routine aneurysm replacement was performed. After the operation, however, the patient developed a septic fever and the abscess was found to be enlarged, which required operative drainage. Thereafter the patient was with transverse colostomy, fistulectomy with partial resection of the sigmoid colon and the urinary bladder, and repair of the colostomy. This case presented a peculiar clinical course that routine aneurysm replacement for AAA performed under our judgment that the abscess was inactivated with medical treatment came out subsequent formation of colovesical fistula.