Introduction: Ureterocolic fistulas are rare, with few cases reported in the literature. Fistula formation as a complication of acute diverticulitis usually occurs in 14% of cases. In a review of the literature, twelve cases of ureterocolic fistulae were described, with the left ureter most frequently affected due to its proximal location to the sigmoid. Patients may present with fecaluria, pneumaturia, and a chronic or recurrent urinary tract infection that can delay the diagnosis. Case Presentation: We present a case of a 56-year-old male patient with recurrent urinary tract infections and no prior history of diverticulitis. An abdominopelvic CT scan showed a colo-right ureteral fistula responsible for pelvicaliceal dilation of the right ureter. The patient underwent elective partial colectomy with colorectal anastomosis and a protective ileostomy, along with JJ insertion of the left ureter after finding an inflammatory mass involving the sigmoid and left ureter. Histopathology confirmed sigmoid diverticulitis and negative reactive lymph nodes.
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