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Clin Colon Rectal Surg 2019; 32(04): 261-267
DOI: 10.1055/s-0039-1683908
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Treatment Strategies in Crohn's-Associated Rectovaginal Fistula

Michelle F. DeLeon
1   Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
,
Tracy L. Hull
1   Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio
› Author Affiliations
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Publication History

Publication Date:
02 July 2019 (online)

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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

rectovaginal fistula - Crohn's disease - surgery - rectal advancement flap - episioproctotomy
 

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