Edelson Scott F D, Edelson Cyrus V, Jones Jacob, Quiles John G
Department of Internal Medicine, Brooke Army Medical Center, San Antonio, TX.
Department of Gastroenterology and Hepatology, Brooke Army Medical Center, San Antonio, TX.
ACG Case Rep J. 2024 Jul 27;11(8):e01452. doi: 10.14309/crj.0000000000001452. eCollection 2024 Aug.
Enterovaginal fistulas (EF) are a rare, pathologic connection between the small bowel and vagina. EF commonly present with abnormal passage of stool, flatus, and purulence through the vaginal orifice, leading to increased risk of severe infections, and cause extreme discomfort for patients. A 70-year-old woman with a history of urothelial carcinoma was treated surgically, resulting in a persistent symptomatic EF. Her course was complicated by multiple failed surgical attempts to fistula closure. Ultimately, she was deemed a poor surgical candidate. Gastroenterology successfully closed her fistula using a cardiac occluder device. This case highlights an innovative solution to treat patients with refractory fistulas.
小肠阴道瘘是小肠与阴道之间一种罕见的病理性连接。小肠阴道瘘通常表现为粪便、气体和脓液经阴道口异常排出,导致严重感染风险增加,并给患者带来极大不适。一名有尿路上皮癌病史的70岁女性接受了手术治疗,术后出现持续性有症状的小肠阴道瘘。她的病情因多次手术尝试闭合瘘管失败而复杂化。最终,她被认为不适合手术。胃肠病科使用心脏封堵器成功闭合了她的瘘管。该病例突出了一种治疗难治性瘘管患者的创新解决方案。