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<p>Colorectal cancer rarely presents with multiple fistulous tracts. We report a 45-year-old woman with sigmoid adenocarcinoma forming two fistulas: one to the cecum and another to the urinary bladder. She presented with pneumaturia, fecaluria, diarrhea, weight loss, and abdominal pain. Imaging revealed a large sigmoid mass with fistulous communications to both structures. Colonoscopy confirmed adenocarcinoma. Surgical exploration revealed unresectable disease with peritoneal metastases; palliative ileostomy and bladder drainage were performed. Double fistula formation is exceptionally rare and indicates aggressive local spread. In such cases, palliation with systemic chemotherapy remains the mainstay when curative resection is not feasible.</p>

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Carcinoma Sigmoid Colon with Double Fistula: A Rare Presentation Involving Cecum and Urinary Bladder

  • 期刊论文

  • 发表日期：

    2025年11月22日

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  • Sanjay Chordiya,
  • Mahaveer Singh Rodha,
  • Binit Sureka,
  • Jeevan Ram Vishnoi,
  • Siddhi Chawla

摘要

Colorectal cancer rarely presents with multiple fistulous tracts. We report a 45-year-old woman with sigmoid adenocarcinoma forming two fistulas: one to the cecum and another to the urinary bladder. She presented with pneumaturia, fecaluria, diarrhea, weight loss, and abdominal pain. Imaging revealed a large sigmoid mass with fistulous communications to both structures. Colonoscopy confirmed adenocarcinoma. Surgical exploration revealed unresectable disease with peritoneal metastases; palliative ileostomy and bladder drainage were performed. Double fistula formation is exceptionally rare and indicates aggressive local spread. In such cases, palliation with systemic chemotherapy remains the mainstay when curative resection is not feasible.