Rectovaginal fistula

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Stage 4 endometrial carcinoma. Clinically rectovaginal fistula. CT Abdomen one month prior - abnormal soft tissue in the pelvis.

Patient Data

Age: 59
Gender: Female
Fluoroscopy

Contrast administered per rectum.

Contrast enters the upper vagina via a fistulous tract from the mid rectum at the level of the lower sacral segments.

Contrast on the 'inko pad' on the patient's bed.

Case Discussion

Rectovaginal fistulas are usually best illustrated on fluroscopic studies.

Advanced gynecological and rectal cancers account for the majority of malignant causes, with complicated diverticular disease the single most common overall cause.

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