A Very Rare Case of Colosalpingeal Fistula Secondary to Diverticulitis: An Overview of Development, Clinical Features and Management.

BACKGROUND: Colosalpingeal fistula is a rare complication secondary to diverticular disease. The pathogenesis is still not clearly understood. We present the case of a colosalpingeal fistula and a review of the management of this pathology. CASE REPORT: A 69-year-old patient with uncomplicated diverticular disease was referred to our department for recurrent vaginal discharge. The clinical examination was unremarkable, hysteroscopy revealed the presence of air in the uterine cavity in the absence of a uterine fistula. A preliminary diagnosis of colosalpingeal fistula was made and was confirmed by computed tomography (CT) scan and hysterosalpingography. A one-stage surgery via laparotomy was successfully performed with remission of the symptoms. CONCLUSION: Colotubal fistula is a rare complication resulting from intestinal diverticular disease. The purpose of this paper was to emphasize the presence of a rare, but serious complication occurring in diverticular disease with atypical symptoms and one-stage surgery treatment.

Unsuspected adverse effect of albumin in severe ovarian hyperstimulation syndrome: a case report.

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complications of in vitro fertilization (IVF). We present a case of OHSS maintained and aggraved by albumin administration. A 29-year-old woman with severe OHSS was treated with albumin perfusion according to the guidelines. The albumin was administered in order to maintain intravascular oncotic pressure and to reverse the shift of fluid from the intravascular to the third space, but this therapeutic measure resulted in inadvertent maintenance of the syndrome. The treatment of OHSS is a delicate balance between invasive approaches, such as paracentesis, administration of colloids and minimal therapeutic intervention, particularly during pregnancy.