A late colon pouch vaginal fistula after low anterior resection – case report and discussion of aetiology

Abstract:

Spontaneous stercoral perforation resulting in rectovaginal fistula is uncommon. A patient is reported who developed a colon pouch vaginal fistula during an episode of severe constipation more than 3 years after successful surgery for rectal cancer. Patients with colon pouch to anus anastomosis may have an incresed lifelong risk of this complication and faecal impaction should be treated urgently. Colon pouch to anus anastomosis has become the standard reconstruction technique following low anterior resection and total mesorectal exision. Early vaginal fistula remains a well recognised complication whether a straight coloanal or a colon pouch to anal anastomosis is performed. No previous report has been found of a late colon pouch vaginal fistula in the absence of radiotherapy or recurrent disease.