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Rectovaginal fistula

MedGen UID:
11152
Concept ID:
C0034895
Anatomical Abnormality; Finding
Synonyms: Fistula, Rectovaginal; Fistulas, Rectovaginal; Rectovaginal Fistula; Rectovaginal Fistulas
SNOMED CT: Rectovaginal fistula (65619001); RVF - Rectovaginal fistula (65619001)
 
HPO: HP:0000143

Definition

The presence of a fistula between the vagina and the rectum. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRectovaginal fistula

Conditions with this feature

Johanson-Blizzard syndrome
MedGen UID:
59798
Concept ID:
C0175692
Disease or Syndrome
Johanson-Blizzard syndrome is an autosomal recessive disorder characterized by poor growth, mental retardation, and variable dysmorphic features, including aplasia or hypoplasia of the nasal alae, abnormal hair patterns or scalp defects, and oligodontia. Other features include hypothyroidism, sensorineural hearing loss, imperforate anus, and pancreatic exocrine insufficiency (summary by Al-Dosari et al., 2008).
Baller-Gerold syndrome
MedGen UID:
120532
Concept ID:
C0265308
Disease or Syndrome
Baller-Gerold syndrome (BGS) can be suspected at birth in an infant with craniosynostosis and upper limb abnormality. The coronal suture is most commonly affected; the metopic, lambdoid, and sagittal sutures may also be involved alone or in combination. Upper limb abnormality can include a combination of thumb hypo- or aplasia and radial hypo- or aplasia and may be asymmetric. Malformation or absence of carpal or metacarpal bones has also been described. Skin lesions may appear anytime within the first few years after birth, typically beginning with erythema of the face and extremities and evolving into poikiloderma. Slow growth is apparent in infancy with eventual height and length typically at 4 SD below the mean.
Acrocallosal syndrome
MedGen UID:
162915
Concept ID:
C0796147
Disease or Syndrome
Classic Joubert syndrome (JS) is characterized by three primary findings: A distinctive cerebellar and brain stem malformation called the molar tooth sign (MTS). Hypotonia. Developmental delays. Often these findings are accompanied by episodic tachypnea or apnea and/or atypical eye movements. In general, the breathing abnormalities improve with age, truncal ataxia develops over time, and acquisition of gross motor milestones is delayed. Cognitive abilities are variable, ranging from severe intellectual disability to normal. Additional findings can include retinal dystrophy, renal disease, ocular colobomas, occipital encephalocele, hepatic fibrosis, polydactyly, oral hamartomas, and endocrine abnormalities. Both intra- and interfamilial variation are seen.
McKusick-Kaufman syndrome
MedGen UID:
184924
Concept ID:
C0948368
Disease or Syndrome
McKusick-Kaufman syndrome (MKS) is characterized by the combination of postaxial polydactyly (PAP), congenital heart disease (CHD), and hydrometrocolpos (HMC) in females and genital malformations in males (most commonly hypospadias, cryptorchidism, and chordee). HMC in infants usually presents as a large cystic abdominal mass arising out of the pelvis, caused by dilatation of the vagina and uterus as a result of the accumulation of cervical secretions from maternal estrogen stimulation. HMC can be caused by failure of the distal third of the vagina to develop (vaginal agenesis), a transverse vaginal membrane, or an imperforate hymen. PAP is the presence of additional digits on the ulnar side of the hand and the fibular side of the foot. A variety of congenital heart defects have been reported including atrioventricular canal, atrial septal defect, ventricular septal defect, or a complex congenital heart malformation.
Oculootoradial syndrome
MedGen UID:
233003
Concept ID:
C1327918
Disease or Syndrome
IVIC syndrome (IVIC) is an autosomal dominant disorder characterized by upper limb anomalies (radial ray defects, carpal bone fusion), extraocular motor disturbances, and congenital bilateral nonprogressive mixed hearing loss. More variable features include heart involvement, mild thrombocytopenia and leukocytosis (before age 50), shoulder girdle hypoplasia, imperforate anus, kidney malrotation, and rectovaginal fistula (summary by Paradisi and Arias, 2007).
Currarino triad
MedGen UID:
323460
Concept ID:
C1531773
Disease or Syndrome
The Currarino syndrome is an autosomal dominant form of hereditary sacral dysgenesis that classically consists of the triad of sacral malformation, presacral mass, and anorectal malformations. However, other features include neonatal-onset bowel obstruction, chronic constipation, recurrent perianal sepsis, renal/urinary tract anomalies, female internal genital anomalies, tethered spinal cord, and anterior meningocele. There is marked inter- and intrafamilial variability, and up to 33% of patients are asymptomatic (summary by Wang et al., 2006).
CODAS syndrome
MedGen UID:
333031
Concept ID:
C1838180
Disease or Syndrome
CODAS is an acronym for cerebral, ocular, dental, auricular, and skeletal anomalies. CODAS syndrome is a rare disorder characterized by a distinctive constellation of features that includes developmental delay, craniofacial anomalies, cataracts, ptosis, median nasal groove, delayed tooth eruption, hearing loss, short stature, delayed epiphyseal ossification, metaphyseal hip dysplasia, and vertebral coronal clefts (summary by Strauss et al., 2015).
Exstrophy-epispadias complex
MedGen UID:
338020
Concept ID:
C1850321
Disease or Syndrome
Carey et al. (1978) gave the name OEIS complex to a combination of defects comprising omphalocele, exstrophy of the cloaca, imperforate anus, and spinal defects. This rare complex is thought to represent the most severe end of a spectrum of birth defects, the exstrophy-epispadias sequence, which, in order of increasing severity, includes phallic separation with epispadias, pubic diastasis, exstrophy of the bladder (600057), cloacal exstrophy, and OEIS complex. Very few instances of recurrence of anomalies in this cluster have been reported.
Ectrodactyly, ectodermal dysplasia, and cleft lip-palate syndrome 1
MedGen UID:
343663
Concept ID:
C1851841
Disease or Syndrome
An EEC syndrome characterized by autosomal dominant inheritance that has material basis in variation in the chromosome region 7q11.2-q21.3.
Craniosynostosis-anal anomalies-porokeratosis syndrome
MedGen UID:
351066
Concept ID:
C1864186
Disease or Syndrome
CDAGS syndrome is characterized by craniosynostosis and clavicular hypoplasia, delayed closure of the fontanel, anal and genitourinary anomalies, and skin eruption of porokeratotic lesions (Mendoza-Londono et al., 2005).
Inflammatory bowel disease 25
MedGen UID:
393403
Concept ID:
C2675508
Disease or Syndrome
Any inflammatory bowel disease in which the cause of the disease is a mutation in the IL10RB gene.
Syndactyly-telecanthus-anogenital and renal malformations syndrome
MedGen UID:
394424
Concept ID:
C2678045
Disease or Syndrome
Syndrome with the association of toe syndactyly, facial dysmorphism including telecanthus and a broad nasal tip, urogenital malformations and anal atresia. Around ten cases have been reported so far. The syndrome is caused by mutations in the FAM58A gene (located on the X chromosome) encoding a protein of unknown function.
BNAR syndrome
MedGen UID:
413305
Concept ID:
C2750433
Disease or Syndrome
FREM1 autosomal recessive disorders include: Manitoba oculotrichoanal (MOTA) syndrome, bifid nose with or without anorectal and renal anomalies (BNAR syndrome), and isolated congenital anomalies of kidney and urinary tract (CAKUT). MOTA syndrome is characterized by an aberrant hairline (unilateral or bilateral wedge-shaped extension of the anterior hairline from the temple region to the ipsilateral eye) and anomalies of the eyes (widely spaced eyes, anophthalmia/microphthalmia and/or cryptophthalmos, colobomas of the upper eyelid, and corneopalpebral synechiae), nose (bifid or broad nasal tip), abdominal wall (omphalocele or umbilical hernia), and anus (stenosis and/or anterior displacement of the anal opening). The manifestations and degree of severity vary even among affected members of the same family. Growth and psychomotor development are normal. BNAR syndrome is characterized by a bifid or wide nasal tip, anorectal anomalies, and renal malformations (e.g., renal agenesis, renal dysplasia). Typically the eye manifestations of MOTA syndrome are absent. FREM1-CAKUT was identified in one individual with bilateral vesicoureteral reflux (VUR) and a second individual with VUR and renal hypodysplasia.
Anorectal anomaly
MedGen UID:
501217
Concept ID:
C3495676
Anatomical Abnormality
An abnormality of the anus or rectum.
Townes-Brocks syndrome 2
MedGen UID:
1381939
Concept ID:
C4479534
Disease or Syndrome
Townes-Brocks syndrome 1
MedGen UID:
1635275
Concept ID:
C4551481
Disease or Syndrome
Townes-Brocks syndrome (TBS) is characterized by the triad of imperforate anus (84%), dysplastic ears (87%; overfolded superior helices and preauricular tags; frequently associated with sensorineural and/or conductive hearing impairment [65%]), and thumb malformations (89%; triphalangeal thumbs, duplication of the thumb [preaxial polydactyly], and rarely hypoplasia of the thumbs). Renal impairment (42%), including end-stage renal disease (ESRD), may occur with or without structural abnormalities (mild malrotation, ectopia, horseshoe kidney, renal hypoplasia, polycystic kidneys, vesicoutereral reflux). Congenital heart disease occurs in 25%. Foot malformations (52%; flat feet, overlapping toes) and genitourinary malformations (36%) are common. Intellectual disability occurs in approximately 10% of individuals. Rare features include iris coloboma, Duane anomaly, Arnold-Chiari malformation type 1, and growth retardation.
Congenital secretory sodium diarrhea 3
MedGen UID:
1778108
Concept ID:
C5441927
Disease or Syndrome
Any secretory diarrhea in which the cause of the disease is a mutation in the SPINT2 gene.
White-Kernohan syndrome
MedGen UID:
1785087
Concept ID:
C5543635
Disease or Syndrome
White-Kernohan syndrome (WHIKERS) is a neurodevelopmental disorder characterized by global developmental delay with variably impaired intellectual development, hypotonia, and characteristic facial features. Some patients may have abnormalities of other systems, including genitourinary and skeletal (summary by White et al., 2021).
Gastrointestinal defects and immunodeficiency syndrome 2
MedGen UID:
1811526
Concept ID:
C5676901
Disease or Syndrome
PI4KA-related disorder is a clinically variable disorder characterized primarily by neurologic dysfunction (limb spasticity, developmental delay, intellectual disability, seizures, ataxia, nystagmus), gastrointestinal manifestations (multiple intestinal atresia, inflammatory bowel disease), and combined immunodeficiency (leukopenia, variable immunoglobulin defects). Age of onset is typically antenatal or in early childhood; individuals can present with any combination of these features. Rare individuals present with later-onset hereditary spastic paraplegia. Brain MRI findings can include hypomyelinating leukodystrophy, cerebellar hypoplasia/atrophy, thin or dysplastic corpus callosum, and/or perisylvian polymicrogyria.

Professional guidelines

PubMed

Gaertner WB, Burgess PL, Davids JS, Lightner AL, Shogan BD, Sun MY, Steele SR, Paquette IM, Feingold DL; Clinical Practice Guidelines Committee of the American Society of Colon and Rectal Surgeons
Dis Colon Rectum 2022 Aug 1;65(8):964-985. Epub 2022 Jul 5 doi: 10.1097/DCR.0000000000002473. PMID: 35732009
Expert Panel on Gastrointestinal Imaging, Levy AD, Liu PS, Kim DH, Fowler KJ, Bharucha AE, Chang KJ, Cilenti E, Gage KL, Garcia EM, Kambadakone AR, Korngold EK, Marin D, Moreno C, Pietryga JA, Santillan CS, Weinstein S, Wexner SD, Carucci LR
J Am Coll Radiol 2021 Nov;18(11S):S268-S282. doi: 10.1016/j.jacr.2021.08.009. PMID: 34794588
Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, Steele SR
Dis Colon Rectum 2016 Dec;59(12):1117-1133. doi: 10.1097/DCR.0000000000000733. PMID: 27824697

Recent clinical studies

Etiology

Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H
J Minim Invasive Gynecol 2021 Mar;28(3):453-466. Epub 2020 Aug 22 doi: 10.1016/j.jmig.2020.08.015. PMID: 32841755
Pope R
Obstet Gynecol 2018 May;131(5):863-870. doi: 10.1097/AOG.0000000000002578. PMID: 29630017
Abu Gazala M, Wexner SD
Expert Rev Gastroenterol Hepatol 2017 May;11(5):461-471. Epub 2017 Mar 1 doi: 10.1080/17474124.2017.1296355. PMID: 28276809
Ommer A, Herold A, Berg E, Fürst A, Schiedeck T, Sailer M
Ger Med Sci 2012;10:Doc15. Epub 2012 Oct 29 doi: 10.3205/000166. PMID: 23255878Free PMC Article
Saclarides TJ
Surg Clin North Am 2002 Dec;82(6):1261-72. doi: 10.1016/s0039-6109(02)00055-5. PMID: 12516853

Diagnosis

Expert Panel on Gastrointestinal Imaging, Levy AD, Liu PS, Kim DH, Fowler KJ, Bharucha AE, Chang KJ, Cilenti E, Gage KL, Garcia EM, Kambadakone AR, Korngold EK, Marin D, Moreno C, Pietryga JA, Santillan CS, Weinstein S, Wexner SD, Carucci LR
J Am Coll Radiol 2021 Nov;18(11S):S268-S282. doi: 10.1016/j.jacr.2021.08.009. PMID: 34794588
Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H
J Minim Invasive Gynecol 2021 Mar;28(3):453-466. Epub 2020 Aug 22 doi: 10.1016/j.jmig.2020.08.015. PMID: 32841755
Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, Steele SR
Dis Colon Rectum 2016 Dec;59(12):1117-1133. doi: 10.1097/DCR.0000000000000733. PMID: 27824697
Champagne BJ, McGee MF
Surg Clin North Am 2010 Feb;90(1):69-82, Table of Contents. doi: 10.1016/j.suc.2009.09.003. PMID: 20109633
Saclarides TJ
Surg Clin North Am 2002 Dec;82(6):1261-72. doi: 10.1016/s0039-6109(02)00055-5. PMID: 12516853

Therapy

Zeng Y, He Y, Li G, Zhi J, Ren B, Lai S, Liu Z, Wang X
Updates Surg 2022 Dec;74(6):1861-1870. Epub 2022 Sep 25 doi: 10.1007/s13304-022-01366-7. PMID: 36161396
Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H
J Minim Invasive Gynecol 2021 Mar;28(3):453-466. Epub 2020 Aug 22 doi: 10.1016/j.jmig.2020.08.015. PMID: 32841755
Bharucha AE, Rao SSC, Shin AS
Clin Gastroenterol Hepatol 2017 Dec;15(12):1844-1854. Epub 2017 Aug 22 doi: 10.1016/j.cgh.2017.08.023. PMID: 28838787Free PMC Article
Sides C, Trinidad MC, Heitlinger L, Anasti J
Obstet Gynecol Surv 2013 Jan;68(1):51-61. doi: 10.1097/OGX.0b013e31827b1658. PMID: 23322081
Champagne BJ, McGee MF
Surg Clin North Am 2010 Feb;90(1):69-82, Table of Contents. doi: 10.1016/j.suc.2009.09.003. PMID: 20109633

Prognosis

Söderqvist EV, Cashin PH, Graf W
Int J Colorectal Dis 2022 Jul;37(7):1699-1707. Epub 2022 Jul 2 doi: 10.1007/s00384-022-04206-7. PMID: 35779081Free PMC Article
Kazi MK, Gori J, Engineer R, Ankathi SKK, Bhuta P, Patel S, Sukumar V, Desouza A, Saklani AP
Female Pelvic Med Reconstr Surg 2022 Feb 1;28(2):115-120. doi: 10.1097/SPV.0000000000001063. PMID: 35084372
Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H
J Minim Invasive Gynecol 2021 Mar;28(3):453-466. Epub 2020 Aug 22 doi: 10.1016/j.jmig.2020.08.015. PMID: 32841755
Ommer A, Herold A, Berg E, Fürst A, Schiedeck T, Sailer M
Ger Med Sci 2012;10:Doc15. Epub 2012 Oct 29 doi: 10.3205/000166. PMID: 23255878Free PMC Article
Kulkarni B, Oak SN, Karmarkar SJ, Desai AP, Deshmukh SS
J Postgrad Med 1995 Apr-Jun;41(2):49-51. PMID: 10707712

Clinical prediction guides

Zeng Y, He Y, Li G, Zhi J, Ren B, Lai S, Liu Z, Wang X
Updates Surg 2022 Dec;74(6):1861-1870. Epub 2022 Sep 25 doi: 10.1007/s13304-022-01366-7. PMID: 36161396
Söderqvist EV, Cashin PH, Graf W
Int J Colorectal Dis 2022 Jul;37(7):1699-1707. Epub 2022 Jul 2 doi: 10.1007/s00384-022-04206-7. PMID: 35779081Free PMC Article
Dobrovodsky A, Pechan J, Duffek M, Skuta R, Hustak R
Bratisl Lek Listy 2022;123(6):389-394. doi: 10.4149/BLL_2022_061. PMID: 35576539
Gupta SK, Pandey A, Kumar P, Srivastava S, Singh S, Rawat J
Pediatr Surg Int 2021 Nov;37(11):1601-1606. Epub 2021 Jul 20 doi: 10.1007/s00383-021-04970-7. PMID: 34286379
Oh C, Youn JK, Han JW, Yang HB, Kim HY, Jung SE, Park KW
J Pediatr Surg 2020 Aug;55(8):1495-1498. Epub 2019 Jul 8 doi: 10.1016/j.jpedsurg.2019.06.021. PMID: 31416593

Recent systematic reviews

Bendifallah S, Puchar A, Vesale E, Moawad G, Daraï E, Roman H
J Minim Invasive Gynecol 2021 Mar;28(3):453-466. Epub 2020 Aug 22 doi: 10.1016/j.jmig.2020.08.015. PMID: 32841755
Kaimakliotis P, Simillis C, Harbord M, Kontovounisios C, Rasheed S, Tekkis PP
J Clin Gastroenterol 2016 Oct;50(9):714-21. doi: 10.1097/MCG.0000000000000607. PMID: 27466166
Hotouras A, Ribas Y, Zakeri S, Murphy J, Bhan C, Chan CL
Colorectal Dis 2015 Feb;17(2):104-10. doi: 10.1111/codi.12791. PMID: 25284745
Adler AJ, Ronsmans C, Calvert C, Filippi V
BMC Pregnancy Childbirth 2013 Dec 30;13:246. doi: 10.1186/1471-2393-13-246. PMID: 24373152Free PMC Article
Ommer A, Herold A, Berg E, Fürst A, Schiedeck T, Sailer M
Ger Med Sci 2012;10:Doc15. Epub 2012 Oct 29 doi: 10.3205/000166. PMID: 23255878Free PMC Article

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