DESPITE the frequency of acute appendicitis, persistence of a patent fistula between the appendix and another viscus is rare. Recently, a fistula between appendix and sigmoid colon, which had been present for many years, was resected. In this instance, preoperative barium enema diagnosis permitted proper preparation and surgical removal of the fistula. Recognition of the patent tract, particularly at operation for acute appendicitis, would probably have been difficult and might have led to postoperative complications. It therefore appears desirable to report this lesion.
Similar instances of fistula between appendix and other viscera have been reported. These include two cases of appendiceal fistula opening into ileum,4 and one each between appendix and Meckel's diverticulum,2 and appendix and ascending colon.3 In each there was history indicative of acute appendicitis previously. Garcia reported an appendiceal-ileal fistula,1 without history indicating previous appendicitis. The muscle layer of the appendix and ileum