MRI enema to check the status of fistula 6 months later.
Volume and standard T2 acquisitions, pre and post introduction of 120 ml of sterile ultrasound gel per anally.
Artefact in the posterior pelvis due to the staples just above the level of the anastomosis (also seen on the prior CT). A persistent rectovaginal fistula is discerned on the pre-gel sequences, with a small volume of high T2 signal in the lumen of the vagina at this level.
The gel causes distension of the rectum and secondary anterior displacement of the rectovaginal septum away from the artefact caused by the staples. Gel is seen to enter an anterior track (from the 12 o'clock position) between the rectum canal and the posterior vagina, indicating a persistent rectovaginal fistula. The fistula looks smaller than on the prior WSCE and CT.