Conservative Management of Coloperitoneal-Vaginal Fistula

Antonia P. Francis, MD, Radu Apostol, DO, Ana Mrkaic, MD, Tara Berman, MD, Ido Sirota, MD, Farr Nezhat, MD

Mount Sinai–Roosevelt Hospital, New York, NY, USA.

ABSTRACT

Introduction: The occurrence of pelvic organ fistulas, after extensive pelvic surgery, has been widely described in the literature, as well as their surgical management via abdominal, vaginal, and laparoscopic approaches. Treatment depends on their etiology and location, as well as the surgeon’s experience.

Case Description: We present the case of a coloperitoneal-colovaginal fistula, a unique clinical scenario. This developed as a complication of robotic-assisted laparoscopic resection of a pelvic mass, treatment of endometriosis, and trachelectomy. A conservative approach was used to treat the patient via interventional radiology-assisted drainage.

Discussion: Successful conservative management of a complex fistula between the colon, peritoneum, and vagina is feasible.

Key Words: Coloperitoneal fistula, Colovaginal fistula, Conservative management, Interventional radiology-assisted drainage.

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