rectovaginal fistula

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Related to rectovaginal fistula: rectocele, Crohn's disease


 [fis´tu-lah] (pl. fistulas, fis´tulae) (L.)
any abnormal tubelike passage within body tissue, usually between two internal organs or leading from an internal organ to the body surface. Some fistulas are created surgically for diagnostic or therapeutic purposes; others occur as result of injury or as congenital abnormalities. Among the many kinds of fistulas, the anal type (fistula in ano) is one of the most common. It generally develops as a result of a break or fissure in the wall of the anal canal or rectum, or an abscess there. Treatment is by surgery.

In women, difficult labor in childbirth may result in formation of a vesicovaginal fistula between the bladder and the vagina with resulting leakage of urine into the vagina. In a vesicointestinal fistula, there is leakage of urine from the bladder into the intestine. In a rectovaginal fistula, feces escape through the wall of the anal canal or rectum into the vagina. This condition, formerly a serious hazard of childbirth, is now rare; like other kinds of fistula, it can be corrected by surgery.

With the types of fistulas described here, typical symptoms are pain in the affected region and an abnormal discharge through the skin near the anus or through the vagina. Fistulas at different places of the body may be caused by tuberculosis, actinomycosis (a fungus infection), the presence of diverticula, or certain other serious diseases, and the fistula itself may be a site of infection and discomfort.
abdominal fistula one between a hollow abdominal organ and the surface of the abdomen.
anal fistula (fistula in a´no) one opening on the cutaneous surface near the anus, which may or may not communicate with the rectum.
arteriovenous fistula one between an artery and a vein, either pathologic (such as a varicose aneurysm) or surgically created to ensure an access site for hemodialysis. The site must be allowed 6 to 8 weeks to mature before it can be cannulated. Such a fistula may be the anastomosis of a natural artery and vein, a bovine graft, or a synthetic polytetrafluoroethylene (PTFE) graft. The bovine graft is taken from the bovine carotid artery and anastomosed to the vein and artery of the patient. In a PTFE graft, fibers are woven into a mesh called Gore-Tex and made into a sleeve and flange; this is available in a variety of sizes.

Precautions necessary to insure patient safety when caring for an individual with an arteriovenous fistula include frequent assessments for adequate circulation in the fistula and the distal extremity. A bruit or thrill can be heard over the access site. Blood pressure measurements, withdrawal of blood, injections, and administration of intravenous fluids should not be done on the extremity with such a fistula.
Internal arteriovenous fistulas.
blind fistula one open at one end only, opening on the skin (external blind fistula) or on an internal surface (internal blind fistula).
branchial fistula a persistent pharyngeal groove (branchial cleft).
Brescia-Cimino fistula an arteriovenous fistula for hemodialysis access, connecting the cephalic vein and radial artery.
bronchopleural fistula one between a bronchus and the pleural cavity, causing an air leak into the pleural cavity; sometimes seen as a complication of empyema, fibrosis, or pneumonia.
cerebrospinal fluid fistula one between the subarachnoid space and a body cavity, such as from head trauma or bone erosion, with leakage of cerebrospinal fluid, usually in the form of rhinorrhea or otorrhea.
complete fistula one extending from the skin to an internal body cavity.
craniosinus fistula one between the cerebral space and a paranasal sinus, permitting escape of cerebrospinal fluid into the nose.
Eck's fistula an artificial communication made between the portal vein and the vena cava.
enterocutaneous fistula see enterocutaneous fistula.
enterovesical fistula one connecting some part of the intestine with the urinary bladder; called also vesicoenteric f.
fecal fistula one between the colon and the external surface of the body, discharging feces.
gastric fistula
1. one communicating between the stomach and some other body part.
2. a passage created artificially through the abdominal wall into the stomach.
horseshoe fistula one near the anus, having a semicircular tract with both openings on the skin.
incomplete fistula blind fistula.
perilymph fistula rupture of the round window with leakage of perilymph into the inner ear, so that changes in middle ear pressure directly affect the inner ear, causing sensorineural deafness as well as dizziness, vertigo, nausea, and vomiting. Head trauma and dramatic changes in atmospheric pressure are the most common causes. The usual treatment is restriction in activity (sometimes with complete bed rest), so that the fistula can heal. Surgical repair may be necessary, consisting of placement of a graft over the defect.
pilonidal fistula pilonidal sinus.
pulmonary arteriovenous fistula a congenital fistula between the pulmonary arterial and venous systems, allowing unoxygenated blood to enter the systemic circulation.
rectovaginal fistula one between the rectum and vagina.
rectovesical fistula one between the rectum and urinary bladder.
salivary fistula one between a salivary duct or gland and the cutaneous surface, or into the mouth through an abnormal pathway.
thoracic fistula one communicating with the thoracic cavity.
umbilical fistula one communicating with the intestine or urachus at the umbilicus.
urinary fistula any fistula communicating between the urinary tract and another organ or the surface of the body.
vesicoenteric fistula (vesicointestinal fistula) enterovesical fistula.
vesicovaginal fistula one from the bladder to the vagina.

rec·to·vag·i·nal fis·tu·la

a fistulous passage connecting the rectum and the vagina.

rectovaginal fistula

Etymology: L, rectus, straight, vagina, sheath, fistula, pipe
an abnormal passage or opening between the rectum and the vagina.


pertaining to the rectum and vagina.

rectovaginal constriction
inherited defect in Jersey cattle; fibrous bands cause dystocia and difficulty performing a rectal examination.
rectovaginal fistula
a common event in mares because of the precipitate nature of the equine birth process. Perforation of the rectovaginal shelf occurs at foaling. The lesion does not extend to include the perineum. Feces accumulate in the rectum and there is a chronic vaginitis. Called also wind-sucking, gill-flirter.
rectovaginal tear
see perineal laceration.
References in periodicals archive ?
Examples including rectovaginal fistula, teat fistula, salivary fistula etc (Tyagi and Singh, 2006).
total subjects 52 1138 1190 Erosion 11 44 55 Infection 6 13 18 Vesicovaginal fistula 16 18 34 Bleeding 19 10 29 Ulceration 10 4 14 Death 4 5 9 Pain and discomfort 2 60 62 Vaginitis 3 14 17 Vaginal discharge 21 35 56 Foul odor 9 18 27 Cancer 9 0 9 Fibrosis 2 0 22 Rectovaginal fistula 2 0 2 Bilateral hydronephrosis with urosepsis 1 0 1 Bowel obstruction 1 0 1 Unilateral hydronephrosis 1 0 1 Ureteric obstruction 1 0 1 Hydronephrosis 1 0 1 Table 2.
8] Rudimentary horn with congenital rectovaginal fistula forms when Mullerian eminences open in the dorsal segment of the endodermal cloaca.
A similar response has been reported in a CD patient who achieved healing of a rectovaginal fistula as well as relief from the associated pain and tenderness (15).
It is tempting to speculate that our patient had suffered from occult focal colonic inflammatory disease that led to her abscess and subsequent rectovaginal fistula, for diverticulitis has been reported as a predisposing cause of ovarian abscess.
It has a learning curve, and because of the potential serious complications--including pelvic sepsis, rectovaginal fistula, and even death--physicians need special credentialing to perform it.
Postpartum, a rectovaginal fistula developed that required several repair operations.
Gastro-intestinal system--Imperforate anus with or without rectovaginal fistula can occur.
In his series, one patient developed a uterovaginal fistula, and another patient developed a rectovaginal fistula, both of which were successfully repaired.
2012) reported a single case of rectovaginal fistula due to prior penetrating injury to the vagina.
I would also offer this tip: When addressing the rectal mucosa, try to stay on a submucosal level, and perform a post-repair rectal exam to ensure that the mucosa has not been violated by a suture and to reduce the risk of rectovaginal fistula.
Commonly encountered conditions include oesophageal atresia with or without tracheoesophageal fistula (TEF), imperforate anus with or without rectovesical or rectovaginal fistula, atresia or stenosis of various parts of GIT (duodenal, jejuna, ileal etc.