Case: 246

Colovaginal Fistula

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History: 47 yo female s/p partial colectomy and Hartmann's procedure. Enema prior to reanastamosis and colostomy takedown.
Solution: Findings in this case are that there is an area of abnormal sigmoid colon (wall irregularity and thickening of folds) and there is contrast tracking from that portion of the colon into a linear collection anterior to the rectum. That represents contrast in the vagina and the patient has a colovaginal fistula. This will likely require surgical correction and certainly, the patient is not ready to be hooked back up.

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