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Sharifaben |
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Case A 56 year old lady presented with passage of flatus and stools from vagina since 1 year. She was diagnosed as a case of multiple gallstones and she had a history of pain in right upper abdomen since 6 months. She had undergone a abdominal hysterectomy before 22 years in gulf country. On examination, abdomen was unremarkable. On vaginal examination the fistulous opening could not be seen and was thought to be high up in the vaginal vault. Barium enema revealed a high vaginal and colonic fistulous tract. |
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She underwent a laparoscopic cholcystectomy and laparoscopic closure of rectovaginal fistula. At surgery, there was a cholecysto-duodenal fistula with adherent gallbladder to duodenum, which was managed laparoscopically with suturing of the duodenum. Postoperatively, she had a persistence of passage of stools per vaginum. She was reoperated by a laprotomy, and after an extensive search for the fistulous tracts, two tracks were found and were ligated under a hysteroscopic guidance. Colostomy was performed. 6 weeks later colostomy was closed and patient had a normal passage of stool and the fistula has healed. |
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