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Colovaginal fistula. Report of a case with failure of transvaginal repair.

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April 1996

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA.

Background: Spontaneous development of colovaginal fistula is a rare cause of abnormal vaginal discharge in older women and most commonly arises from diverticular disease. Laparotomy for segmental colonic resection is the accepted treatment. The author found no previous reports of attempted transvaginal closure of these fistulae, although such closure of similar fistulae can sometimes be accomplished in patients with Crohn's disease when quiescence is achieved.

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The most feared complication of anterior and low anterior resection is anastomotic dehiscence. Although most leakages remain clinically silent, some may lead to formation of a colovaginal fistula. At the Lahey Clinic Medical Center, the records of nine patients with colovaginal fistula as a complication of colorectal surgery were reviewed to determine clinical characteristics and optimal management.

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