Up to 25% of patients with acute
diverticulitis develop complicated disease. Colocutaneous
fistula with lower limb
fasciitis secondary to complicated
diverticulitis is a rare event. A 71-year-old woman with Class 3
obesity and
Type 2 diabetes was admitted to the hospital because of left lower limb
fasciitis associated with acute sigmoid
diverticulitis complicated by covered perforation. The
fasciitis was treated with multiple fasciotomies,
antibiotics and
hyperbaric oxygen therapy. The patient was readmitted 25 days after discharge because of the formation of a left leg colocutaneous
fistula associated with an enterocolic
fistula. Patient underwent sigmoid resection with primary anastomosis and ileal loop repair. Three-month follow-up showed
fistula healing and absence of symptoms.
Fasciitis secondary to acute
diverticulitis is a rare clinical scenario. Although our therapeutic strategy was successful, the optimal treatment timing and surgical technique for
fasciotomy and colon resection remain to be assessed.