Findings
The patient is a known case of carcinoma rectum who has undergone Radiotherapy. Axial T2 image(1) shows circumferential mural thickening of the rectum(also seen in sagittal T2 – image 2) with mesorectal lymphadenopathy(metastasis). There is defect seen in the anterior wall of rectum that communicates with the vaginal cavity. This is better visualized in the axial T1(3) and to further confirm the diagnosis, rectal contrast was administered(4) that revealed rectovaginal fistula.
Diagnosis
Rectovaginal fistula in carcinoma rectum.
Summary
Carcinoma and Radiotherapy are predisposing factors to development of rectovaginal fistula. If suspicion is high, positive rectal contrast is imperative for confirmation of diagnosis.
Further reads
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