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Colocutaneous fistula following Clostridioides difficile infection managed as an ‘autocolostomy’: a novel approach to a recognised complication
  1. Marriam Ahmed1,
  2. Kiran Randhawa2,
  3. Anthony Kawesha1 and
  4. Akinfemi Ayobami Akingboye1
  1. 1General Surgery, The Dudley Group NHS Foundation Trust, Dudley, UK
  2. 2Radiology, The Dudley Group NHS Foundation Trust, Dudley, UK
  1. Correspondence to Akinfemi Ayobami Akingboye; a.akingboye{at}nhs.net

Abstract

Colocutaneous fistula is a rare entity in colorectal disease. We present a case of colocutaneous fistula in a patient whose postoperative course following a laparoscopic anterior resection for sigmoid cancer was complicated by Clostridioides difficile colitis. During the follow-up period, it was found that his bowel contents were preferentially discharging through this fistula which had taken up the role of an ‘autocolostomy’. Given the physiological impact of an additional surgical procedure, a definitive repair of the fistula was deferred and instead the patient was taught to manage it in keeping with general principles of stoma care. Over the subsequent follow-up period, he has now developed a large parastomal hernia and is being considered for definitive repair.

  • gastrointestinal surgery
  • general surgery
  • gastrointestinal system
  • colon cancer

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Footnotes

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  • Contributors MA drafted the manuscript. KR reviewed the patient’s imaging results and recommended which ones best showed the progression of the disease. He also drafted the legend for the CT images. AK was the consultant responsible for this patient’s care. AAA- was the senior and corresponding author, reviewed initial drafts of the manuscript and edited them. He was involved in explaining the process of submission to the patient and procured all the necessary medical records and supplemental materials. He responsed to all the reviewers comments.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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