PMC5863024_01
Colonic stricture.
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Her CT scan showed a normal uterus and a 4 cm right adnexal collection of fluid and gas, with adjacent midsigmoid wall thickening, concerning for stricture (see Fig. 1).
Colonic stricture on barium enema.
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A left colonic stricture was clearly delineated on the barium enema (see Fig. 2), so subsequently a colonoscopy was performed.
Colonoscopy.
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There was an area of tight stricture just past the sigmoid colon which could not be traversed (see Fig. 3), and the biopsy taken showed well to moderately differentiated invasive colorectal adenocarcinoma.
Gross specimen, colon, uterus, tubes, and ovaries.
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On pathologic examination, the uterus and left ovary were remarkable for an 8 cm fistula tract between the perforated serosa of the colon and the left tubal ostia (see Fig. 4).