Colo-ovarian fistulization is a rare complication of serous adenocarcinoma of the ovary. This clinical case provides insight into its pathophysiological consequences and the best therapeutic approach in this unusual situation.

Although sigmoidal diverticulitis is a prevalent medical-surgical condition, the clinician may be misled in his or her diagnosis due to the plethora of findings. We describe through this clinical case an isolated retropneumoperitoneum secondary to a sigmoiditis by detailing the reasoning behind our approach.

The main objective of this case report is to critically evaluate the difficulties associated with the diagnosis and treatment of a rare endogenous intestinal perforation, represented by an impacted gallbladder stone; thus increasing the awareness of jejunal perforation and small bowel diverticula.