Colo-articular fistula following a Girdlestone resection arthroplasty

Abstract

Colo-articular fistulas are rare complications that are usually associated with inflammatory, infective or malignant bowel disease. We report the case of a 44-year-old male who was found to have a colo-articular fistula intra-operatively during the washout of a septic hip joint. The patient had no pre-existing bowel disease, but was an intravenous drug user, who had previously undergone a Girdlestone procedure for osteomyelitis of the proximal femur. The patient was managed through a multi-disciplinary team approach with subsequent debridement and formation of a transverse loop colostomy to control the faeculent fistulous discharge.

Figure 1:

(a) Coronal slice from a CT scan of the abdomen and pelvis showing the left hip gridlestone with the presence of air in the joint space. (b and c) Axial images demonstrating air in the lower rectum with involvement of the left ischial fossa and passage along the obturator canal to the left hip joint.