Colouterine fistula: A case report of a rare complication of diverticular disease managed during the pandemic.

• Diverticular disease may result in complications like inflammation, abscess, bleeding and formation of fistula to adjacent organs. • Colouterine fistula secondary to diverticular disease are extremely rare. • Accurate diagnosis of a colouterine fistula requires correlation of clinical presentation, properly selected radiologic examination and endoscopic evaluation. • Colouterine fistulas from other causes must be considered to properly select appropriate management. • The surgical treatment of choice will be dictated by patient factors, local tissue conditions and available expertise. Colouterine fistulas related to diverticulitis are very rare due to the thickness of the uterine myometrium. Other causes related to colouterine fistula formation particularly malignancy, have to be considered. Diagnosis by imaging or endoscopy may be inconclusive. We are presenting a case of a 70-year-old female who presented with malodorous vaginal discharge and painful labial lesions. No previous history of surgery, gynecologic malignancy or other possible causes of the fistula was elicited. CT scan imaging suggested a colouterine fistula. The patient was admitted and underwent Exploratory laparotomy, Hartmann's procedure and total hysterectomy with bilateral salpingo oophorectomy. The patient was discharged without perioperative complications. Colouterine fistulas are extremely rare complications of diverticular disease. Diagnosis entails clinical astuteness and judicious use of imaging and endoscopic modalities. Accurate diagnosis is essential to select the appropriate surgical approach, along with intraoperative findings patient status and prevailing conditions. This case is being presented not only for the rarity of the case but also for the complexity of the management and decision making during the period of the pandemic. [ABSTRACT FROM AUTHOR]