Large Intestine: Colovaginal Fistula

General Enteric Fistulas

• *See Large Intestine: General Enteric Fistula

Basics

• A Fistula from the Colon to the Vagina
• Most Common on the Left Side

Causes

• Diverticulitis – Most Common (80-90%)
• Crohn’s Disease
• Malignancy

Symptoms

• Gas from the Vagina
• Feces from the Vagina
• Abdominal Pain

Diagnosis

• Dx: Varied
  • Vaginal Exam & Anorectal Exam
  • CT with Oral/Rectal Contrast – Sensitivity Controversial
  • Colonoscopy to Rule Out Malignancy

Treatment

• Tx: Elective Surgery
  • Segmental Bowel Resection
  • Generally Able to Preform Primary Anastomosis
  • Vagina Management Varies – Primary Closure vs Left Open
  • Consider Omentum Interposition

Rectovaginal Fistula

• *See Anorectal: Rectovaginal Fistula