Erschienen in:
13.05.2017 | Trick of the Trade
Colonoscope-mediated vaginoscopy for diagnostic evaluation of colovaginal fistulas
verfasst von:
Nicholas Latchana, Iyare Esemuede, Alan Harzman, Mark Arnold, Syed Husain
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 5/2017
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Excerpt
While most patients with colovaginal fistulas present with typical symptoms and typical findings on physical examination, establishment of a concrete clinical diagnosis can be difficult in patients with vague symptoms or an equivocal physical examination. A myriad of diagnostic adjuncts are available including speculum examination, barium enema, colonoscopy and computed tomography (CT) yet none are able to consistently identify the location and etiology of the colovaginal fistula with absolute certainty [
1]. Pelvic examination with a speculum correctly identifies colovaginal fistulas in only 43% of cases [
2]. Barium enema is also a poor test for the diagnosis of colovaginal fistulas as suggested by Holroyd et al. [
3] who found a sensitivity of 30.8% for the identification of colovaginal and colovesical fistulas. This problem is compounded by the lack of consensus regarding optimal diagnostic workup, thereby leading to a multitude of suboptimal diagnostic tests for many patients with the potential for increased healthcare costs [
3] and patient inconvenience. …
