Long-Tube Coiling in Enterocolonic Fistula

AN ENTEROCOLONIC fistula is an uncommon complication of diverticular disease¹ and has no distinctive clinical features.^1,2 Barium enema examinations invariably show an abnormality of the pelvic colon but may outline the fistulous tract in only 30% of subjects.^1-4 The diagnosis of the fistulous tract in a patient in whom an enterocolonic fistula secondary to diverticular disease developed was made by the progression of a Miller-Abbott tube through the communication not once but twice.

Report of a Case  A 62-year-old man with a history of acute diverticulitis six years ago was admitted to the Hospital of the University of Pennsylvania for evaluation of intermittent diarrhea of two months' duration. Symptoms included progressive anorexia, weight loss of 9.1 kg, and intermittent bloating. A barium enema examination was performed and showed diverticular disease of the sigmoid colon.On admission he had a mildly distended tympanitic abdomen with normal bowel sounds; his