PMC6927061_01
Transvaginal ultrasound on postoperative day 34 showing a hypoechoic cystic area adjacent to the uterus right posteriorly, measuring 65.4 mm x 27.3 mm.
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She was free of complaints, but transvaginal ultrasound showed a hypoechoic cystic shadow adjacent right posteriorly to the uterus (Figure 1).
Transvaginal ultrasound on postoperative day 62 showing dilated uterine cavity ((a), arrowheads). The cystic echo observed on day 34 still exists but decreased in size ((b), arrows, 29.8 mm x 15.1 mm).
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Transvaginal ultrasound revealed dilated uterine cavity suggestive of fluid retention (Figure 2(a)). The cystic hypoechoic shadow on day 34 still existed but decreased in size (Figure 2(b)).
Right retrograde pyelography demonstrating stricture of the right ureter (arrow) and its deviation to the left side, from which a fistula into the sigmoid colon is observed (arrowheads). Extravasation of contrast into the mid-pelvis is also present right above the narrowing of the ureter (hollow arrow), suggestive of a fistula to the peritoneum.
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Retrograde pyelography revealed that the right ureter was narrowed and shifted to the left at the level of the uterosacral ligament, with a fistula leading to the sigmoid colon (Figure 3). 
Coronal (a) and axial (b) scan of pelvic CT after retrograde pyelography. Contrast used for retrograde pyelography remains in the sigmoid colon (arrow).
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Barium enema showing contrast leakage from the sigmoid colon (arrow).
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