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Rectovaginal fistula

Case contributed by Joaquin Vidal
Diagnosis certain

Presentation

Patient begins with alteration of the bowel habit, alternating episodes of constipation and diarrhea. Months later she adds proctorrhagia, pain in the anal region and fecal discharge through the vagina.

Patient Data

Age: 35 years
Gender: Female
mri

In the lower-middle rectum, there is a parietal, annular, semicircumferential image compatible with a primary organic lesion. On the anterior aspect there is ample contact with the vagina, even communication with the vagina in the cupula, close to the cervix (rectovaginal fistula).

Case Discussion

Colovaginal and/or rectovaginal fistulas can generate symptoms such as vaginitis, passage feces through the vagina and pain. They depend on the type of fistula, the most frequent being vesicovaginal and rectovaginal.

Its etiology includes obstetric complications, inflammatory bowel disease, post-surgical causes, pelvic neoplasms, trauma, infections, among others.

Pelvic malignant tumors can cause tissue destruction leading to the formation of fistulas.

They require treatment and long-term follow-up to ensure their occlusion.


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