Concomitant rectovaginal fistula: an unusual intraoperative presentation

Abstract

Background: Rectovaginal fistula usually presented with pelvic organ prolapse. However, rectovaginal fistula, giving a channel for the flow of feces into vagina during hysterectomy (a strange presentation), to the best of my knowledge, such a finding has not been reported in the literature.

Case presentation: A middle-aged patient underwent total abdominal hysterectomy for 2nd degree cervical descent at Government THQ hospital, Lahore in October 2023. Fecal matter shown up in vagina upon suction before vaginal vault closure. This presentation of fecal matter led to identification of rectovaginal fistula intra-operatively.

Conclusion: Pre-operative comprehensive clinical examination could help to identify asymptomatic rectovaginal fistula.