eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-01-25 10 2 39 41 10.12691/ajmcr-10-2-5 AJMCR20221025 article Luis M. Nieto dr_luismiguelnieto@hotmail.com 1 Sharon Narvaez 2 Sanskriti Sharma 2 Luther Burse 3 Department of Internal Medicine, WellStar Atlanta Medical Center, Atlanta, Georgia, USA Facultad de Ciencias Medicas, Universidad de Guayaquil, Ecuador Gastroenterology consultant, WellStar Atlanta Medical Center, Atlanta, Georgia, USA A 49-year-old African American male with history of diverticulitis presented to the ED with abdominal pain and feculent discharge from the umbilicus. CT scan of the abdomen showed a fistulous tract from the sigmoid colon to the umbilicus. Labs revealed a markedly elevated fecal calprotectin level and colonoscopy demonstrated friable-appearing mucosa of the sigmoid colon. Segmental colitis associated with diverticulosis (SCAD) refers to a chronic, localized, nongranulomatous inflammation, usually in the sigmoid colon. SCAD spares the rectum and the proximal colon endoscopically and histologically. We present a case of diverticular disease associated with an unusual fistula and features of SCAD. http://pubs.sciepub.com/ajmcr/10/2/5/ajmcr-10-2-5.pdf diverticulosis diverticulitis fistula Segmental Colitis