Presentation
Known rectal malignancy. Defaulted and refused treatment. Returns several months later.
Patient Data
Circumferential thickening of the distal rectum, with extra-serosal extension (best observed at 8 and 12 o'clock).
Extensive mesorectal lymphadenopathy and large metastatic mass.
Annotations indicating the fistulous tract (arrows) between the vagina (V) and the rectum (R), in which is a tumor.
Case Discussion
Colovaginal fistula are most commonly observed in the context of advanced colorectal malignancy or severe diverticular disease.
The fistula may be identified on CT, MRI or fluoroscopy.
A tract is evident with air communication from the rectum into the vagina.