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Review
. 2019 Jul;32(4):261-267.
doi: 10.1055/s-0039-1683908. Epub 2019 Jul 2.

Treatment Strategies in Crohn's-Associated Rectovaginal Fistula

Michelle F DeLeon  1 , Tracy L Hull  1
Affiliations
Review

Treatment Strategies in Crohn's-Associated Rectovaginal Fistula

Michelle F DeLeon et al. Clin Colon Rectal Surg. 2019 Jul.

Abstract

Rectovaginal fistula (RVF) is a rare, but dreaded complication of Crohn's disease (CD) that is exceedingly difficult to manage. Treatment algorithms range from observation and medical therapy to local surgical repair and proctectomy. The multitude of surgical options and lack of consensus between experts speak to the complexity and shortcomings encountered to correct this disease process surgically. The key to successful management of these fistulae therefore rests on a multidisciplinary approach between the patient, gastroenterologists, and surgeons, with open communication about expectations and goals of care. In this article, we review the management of CD-associated RVF with an emphasis on surgical technique.

Keywords: Crohn's disease; episioproctotomy; rectal advancement flap; rectovaginal fistula; surgery.

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Figures

Fig. 1
Fig. 1
Algorithm of treatment.
Fig. 2
Fig. 2
Algorithm for surgical closure.
See this image and copyright information in PMC

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