A 40-year-old lady presented to the emergency department with the complaint of lower abdomen pain and the passage of stools and flatus per vagina for the past two months. The patient described the pain as dull aching, non-radiating, and progressively increasing in intensity for the past four months. Patient history The patient had undergone total abdominal hysterectomy eight months back at another health center, following which she developed rectovaginal fistulas (RVF). A transverse colostomy was done to divert stools away from the RVF. The patient had no other comorbidity.
Physical examination Vitals were within normal limits. Abdominal examination revealed a transverse colostomy in the right upper quadrant and a horizontal scar of the previous hysterectomy in the hypogastrium. The abdomen was soft, non-tender, and there was no palpable lump/swelling. Rectal and vaginal examination…
