Abstract
Diverticular diseases uncommonly occur at a young age. However, its prevalence in younger individuals is rising. Atypical presentations will lead to misdiagnoses and unindicated surgery. Colovesical fistulas remain the most common type that is associated with diverticular diseases. A 16-year-old female patient presents with 2 months history of left-sided lower abdominal pain, in addition to, longstanding history of urinary incontinence since early childhood. Imaging studies, including computed tomography and magnetic resonance imaging, revealed complicated sigmoid diverticulitis by fistula formation to the urinary bladder and uterus, possible fistula to the vagina and rectum. The patient underwent successful surgical intervention, including sigmoidectomy, closure down of the colovesical fistula, and keeping of the vesicouterine fistula with plans for future repair by a specialized urogynecologist.