Tuboovarian Abscess Secondary to Sigmoid Diverticulitis

A 52-year-old woman was referred for treatment of an umbilical hernia. On initial presentation, she denied abdominal pain. Physical examination demonstrated mild lower abdominal tenderness, and laboratory data revealed slightly elevated inflammatory response. However, abdominal computed tomography (CT) scan showed intraperitoneal free air and an abscess in the pelvis. She was admitted with suspected gastrointestinal perforation, and antibiotic treatment was performed. She had no symptoms after discharge. Follow-up abdominal CT scan 4 months later showed a persistent abscess cavity with a large air collection in the right lower quadrant. We performed an operation with the preoperative diagnosis of intraabdominal abscess caused by sigmoid diverticulitis. An abscess with a thick wall adhering firmly to the right ovary and fimbriae of the fallopian tube was found and a fistula between a sigmoid diverticulum and the right fallopian tube was detected. A right tuboovarian abscess due to sigmoid diverticulitis was suspected and right salpingo-oophorectomy and partial resection of the sigmoid colon were performed. We must consider the possibility of fistula formation to adnexa when investigating and treating colonic diverticulosis with a pelvic abscess.