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
