Rectovaginal fistula

Case contributed by Dr Ian Bickle

Presentation

Known rectal malignancy. Defaulted and refused treatment. Returns several months later.

Patient Data

Age: 55
Gender: Female
CT

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.

Annotated image

Annotations indicating the fistulous tract (arrows) between the vagina (V) and the rectum (R), in which is a tumour.

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.

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Case information

rID: 31182
Case created: 22nd Sep 2014
Last edited: 18th Jul 2016
Inclusion in quiz mode: Included

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