A fistula between the appendix and sigmoid colon is uncommon and often misdiagnosed unless imaging studies are available.
Risk factors:
(1) appendiceal or colorectal carcinoma
(2) ulcerative colitis
(3) acute appendicitis
(4) diverticulitis
(5) appendix long and mobile enough to reach the sigmoid colon
Presentation:
(1) “polyp” seen at sigmoidoscopy (tip of the appendix extending into colon)
(2) imaging studies showing luminal contrast extending between sigmoid colon and appendix
(3) fistula track identified at surgery
(4) intra-abdominal pain
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Specialty: Gastroenterology
