Colo-ovarian fistula masquerading as tubo-ovarian abscess: a case report

Colo-ovarian fistulas are rare, diagnostically challenging, and often misidentified as gynecologic pathology. Early recognition with contrast-enhanced CT-including selective use of rectal contrast-may improve diagnostic accuracy and facilitate timely management. Definitive treatment generally requires surgical resection, and multidisciplinary coordination is critical to optimizing outcomes. This case adds to the limited literature by emphasizing both the diagnostic value of rectal contrast and the importance of timely surgical intervention, providing clinicians with an example of a systematic approach to complex pelvic infections.