Enterovaginal fistula as a complication of intraoperative small bowel endoscopy.

Intraoperative endoscopy has been accepted as a method of small bowel evaluation for occult gastrointestinal bleeding. Although methodology of the procedure has been evolving, reported complications have been few, consisting of prolonged ileus, adhesions, submucosal hemorrhage, and serosal injuries. This case report describes an enterovaginal fistula as a complication of intraoperative small bowel endoscopy performed during a total colectomy procedure in a patient with chronic gastrointestinal bleeding, possibly caused by ischemia resulting from pleating of small bowel over the endoscope. This complication may be prevented by use of longer commercially available enteroscopes or by use of an enterotomy to insert the endoscope.