Spontaneous vaginoperitoneal fistula as a rare complication of carcinoma ovary: a case report

Tarang Preet Kaur,Asmita M Rathore,Sangeeta Bhasin

doi:10.1186/s43046-021-00099-9

Abstract

BackgroundSpontaneous vaginoperitoneal fistula formation in a case of carcinoma ovary is a very rare occurrence and has never been reported.Case presentationA 55-year-old postmenopausal lady presented with complaints of abdominal distention and mass coming out of the vagina for the last 10 days. On examination, she had tense ascites, uterovaginal prolapse and hard, fixed mass felt anteriorly on per-rectal examination. Biochemical investigations and radiological imaging suggested advanced stage ovarian neoplasm. She was planned for neoadjuvant chemotherapy. During the second cycle of chemotherapy, she developed spontaneous vaginoperitoneal fistula which was confirmed on exploratory laparotomy where interval debulking surgery was performed in collaboration with gastro-surgeons on a semi-emergency basis. The postoperative course was uneventful.ConclusionSpontaneous vaginoperitoneal fistula is a rare complication and should be kept in mind while managing advanced ovarian neoplasm.

Highlights

BackgroundA fistulous communication between the vagina and the bladder, urethra, ureter or rectum following an abdominopelvic surgery is a common cause of continuous vaginal discharge or urinary leakage
Spontaneous vaginoperitoneal fistula formation in a case of carcinoma ovary is a very rare occurrence and has never been reported.Case presentation: A 55-year-old postmenopausal lady presented with complaints of abdominal distention and mass coming out of the vagina for the last 10 days
We found few case reports of vaginoperitoneal fistula, out of which only two developed spontaneously, the rest developed after hysterectomy

Summary

Background

A fistulous communication between the vagina and the bladder, urethra, ureter or rectum following an abdominopelvic surgery is a common cause of continuous vaginal discharge or urinary leakage. A preoperative diagnosis of FIGO stage IV ovarian carcinoma was made and she was planned for neoadjuvant chemotherapy followed by interval debulking and adjuvant chemotherapy She received her first cycle of paclitaxel and carboplatin-based chemotherapy uneventfully. A defect measuring 3 × 3 cm was seen in the posterior vaginal wall 1 cm from the cervical os (Fig. 3). It had ragged and necrotic margins and fluid with mucus flakes was seen draining out through it.

Discussion

Conclusions