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Colovesical and colovaginal fistula in advanced colorectal cancer

Case contributed by Omar Rajaram
Diagnosis certain

Presentation

Patient with a history of colorectal cancer, treated with multiple radiotherapy sessions. She came to the ER with leakage of fecal material thru the vagina cavity.

Patient Data

Age: 60 years
Gender: Female

Irregular wall thickening of the middle and upper segments of the rectum. Rectum shows avid enhancement after the application of paramagnetic contrast. In the 12o’clock radius, there is an abnormal fistulous tract, that communicate towards the posterior vaginal fornix and the bladder, it associates striation of adjacent fat.

Case Discussion

There is a high incidence of rectovaginal fistulae in patients with a history of colorectal cancer and multiple radiotherapy sessions. It is associated with the formation of fistulous tracts between cavities.

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