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Rectovaginal fistula

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Known recurrent rectal malignancy. Clinical impression of a rectovaginal fistula.

Patient Data

Age: 35 years
Gender: Female
ct

Low rectal anastomosis.

Recurrent perianastomotic soft tissue, in keeping with tumor recurrence.

A catheter placed in the rectum for administration of contrast ( water as a negative contrast agent ) traverses the anterior rectal wall, with the tip in the vaginal fornix.

The water fills the vaginal which is distended, along with foci of gas.

Normal bladder.

Case Discussion

Colovaginal fistula most commonly occur with pelvic malignancies.

This case illustrates the fistula using rectal ''contrast'' administration, which fills the vaginal, but furthermore the catheter enters the vagina itself from the rectal placement.

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