ABSTRACT
BACKGROUND: Fistula formation is a known complication of diverticulitis. Treatment of a diverticular fistula depends on the comorbidity of the patient and the severity of the disease. CASE REPORT: A 59-year-old man presented to the Emergency Department with chronic lower back pain that was being treated with a neurostimulator. He presented with severe sepsis, and an abscess formation near the neurostimulator. An abdominal and pelvic computed tomography scan revealed diverticulitis complicated by fistula formation to the neurostimulator and bladder. He was successfully treated by a two-stage procedure: first, exploration and drainage of the abscess, with removal of the foreign body, followed by a sigmoid resection 1 week later. CONCLUSION: In rare but severe presentations of diverticular disease, it is very important to limit initial treatment to the most threatening disorder.