Presentation
Known uterine and cervical mass treated with radiotherapy, and discharging stool from the vagina.
Patient Data
Circumferential wall thickening is seen involving the anal canal measuring about 1.8 cm in thickness with an ill-defined contrast-filled track seen connecting the anterior wall of the anal canal and extending through the posterior vaginal wall with flow of the contrast through the vaginal orifice.
The uterus appears bulky showing moderate intra-cavitary fluid density and also extending to fill the cervical canal.
Multiple ill-defined gas densities are seen along the posterior cervical lip as well as within the cervical canal.
Small midline hernial defects are noted.
Contrast enema through an anal canal catheter shows the contrast-filled track.
Case Discussion
Recto-vaginal fistulas in this case occurred as a complication of radiotherapy, it also can result from iatrogenic injury, inflammatory bowel disease (Crohn disease), and pelvic malignancy.
Can be diagnosed with fluoroscopy or through contrast injection into the anal canal.
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