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Erschienen in: International Urogynecology Journal 6/2017

19.10.2016 | Images in Urogynecology

Sigmoid–vaginal fistula as a rare complication following vaginal surgery

verfasst von: Sasa Ljustina, Rajka Argirovic, Vasko Tosic, Sasa Kadija

Erschienen in: International Urogynecology Journal | Ausgabe 6/2017

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Excerpt

A 75-year-old woman presented complaining of mucoid, foul-smelling vaginal discharge, and dull lower abdominal pain. She had undergone a vaginal hysterectomy and anterior colporrhaphy for a prolapsed uterus and cystocele 4 years earlier. The same year, 9 months later, vaginal vault prolapse occurred; thus, sacrospinous fixation of the vagina was performed. Examination revealed complete vaginal eversion with enterocele and an unusual circular opening on the vaginal cuff (Fig. 1). The opening was admissible with one finger, and the entered structure squeezed the finger so that a peristaltic wave was considered to have occurred (Fig. 2). MRI examination did not describe the presence of fistula formation. However, as the patient’s symptoms and clinical examination conclusively indicated a diagnosis of fistula, surgical treatment was chosen. Laparotomy was performed, and sigmoid colon was found attached to the vaginal cuff. After dissection, a defect of the sigmoid colon wall appeared (Fig. 3). The bowel portion involved was resected, and primary re-anastomosis was performed. Debridement and layer closure of the vagina were also performed. Vaginal vault prolapse and enterocele were corrected by the interpositioning of Elevate posterior mesh. The patient recovered well. She was last seen 3 months after the operation.
Literatur
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Zurück zum Zitat Kovac SR, Zimmerman CW. Advances in reconstructive vaginal surgery. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2012. Kovac SR, Zimmerman CW. Advances in reconstructive vaginal surgery. 2nd ed. Philadelphia: Lippincott Williams and Wilkins; 2012.
2.
Zurück zum Zitat Mathevet P, Valencia P, Cousin C, Mellier G, Dargent D. Operative injuries during vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2001;97(1):71–5.CrossRefPubMed Mathevet P, Valencia P, Cousin C, Mellier G, Dargent D. Operative injuries during vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2001;97(1):71–5.CrossRefPubMed
Metadaten
Titel
Sigmoid–vaginal fistula as a rare complication following vaginal surgery
verfasst von
Sasa Ljustina
Rajka Argirovic
Vasko Tosic
Sasa Kadija
Publikationsdatum
19.10.2016
Verlag
Springer London
Erschienen in
International Urogynecology Journal / Ausgabe 6/2017
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-016-3180-8

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