ABSTRACT
INTRODUCTION: Congenital colonic pouch syndrome is an extremely rare condition, particularly in Western countries. In this condition, the colon is replaced with a partially or completely abnormal pouch, connected to the genitourinary tract by a ?stula or may end in a blind pouch. As it is a congenital condition, the cases reported are found in the neonatal population, so its detection in adulthood is extremely rare. We present the CASE PRESENTATION: case of a 43-year-old female, who was admitted to the general surgery service with suspected ?stulizing CROHN's disease. She attended with a two-month clinical picture, presenting a painful ulcer in the left perianal and gluteal region, accompanied by discharge of purulent material and feces through the vaginal introitus. Laboratory tests (CAT, colonoscopy and MRI) did not present conclusive information. An exploratory laparotomy was performed, ?nding a congenital type I colonic pouch, so it was resected, and a terminal ileostomy was performed. The present case aimed to report our experience with a CONCLUSIONS: pathology that has not been reported in this particular age group in our country. Imaging studies before surgery were unable to diagnose the pathology, so the exploratory laparotomy was decisive for the treatment.