Sigmoidovaginal fistulas. A study of 37 cases.

Abstract

FISTULAS between the sigmoid colon and the vagina are a relatively infrequent occurrence. Zeigerman and associates1recently collected reports of 20 cases of sigmoidovaginal fistulas, added one new one, and found that diverticulitis was the most common cause of these lesions. Other causal factors included irradiation for carcinoma of the cervix, hysterectomy, appendectomy, pelvic tuberculosis, a perforating chicken bone, and a perforating tooth from a dermoid cyst. In one case, the fistula apparently occurred spontaneously. The value of vaginography was demonstrated by Lambie and coworkers2and by Coe,3each of whom reported two cases of sigmoidovaginal fistula. Bradford4added two more cases of sigmoidovaginal fistula complicating sigmoidal diverticulitis. From 1940 through 1963, 39 patients with sigmoidovaginal fistula were treated surgically at the Mayo Clinic. Two patients in whom such a communication occurred at the anastomosis of a previous bowel resection were excluded, leaving a total of