Abstract
BACKGROUND: Few cases with fistulous communication between the GI system and female adnexal structure have been reported in the literature, and bilateral contrast spillage has been reported only in one case, and this case is the second one all over the world. CASE PRESENTATION: The case was a 27-year-old woman with a diagnosis of primary infertility. She was booked with hysterosalpingogram (HSG) as part of the routine workup in the infertility clinic. There was a positive history of pelvic surgery for bilateral adnexal cysts for her in 2014. In this case, previous pelvic surgery without any medical problems was the strongest risk factor for tubo-intestinal fistula. Cystectomy performed for the left adnexal cyst and the right adnexal cyst was only drained. The pathologic report for the left ovarian cyst was endometriosis. HSG result showed evidence of bilateral fallopian tube opacification with contrast outlining from the fallopian tubes. Contrast leakage happened to the adjacent small intestine in the right side and peritoneal cavity on the left side. CONCLUSION: Fistulous connections between fallopian tube and intestine will remain an exceptional rarity. The reported case could be a good lesson illustrating that the adherence to general surgical principles (meticulous hemostasis, careful applying of diathermy, etc.) and a watchful postoperative care could protect the patient from both usual and unusual complications.