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Finding RV fistulasFrom: Daniel Flaherty (drdanf@dailypost.com)Tue May 30 18:27:25 2000
Hi, I saw a patient today for a return visit concerning a chronic foul odor vaginal discharge. She had a vaginal delivery last fall by another doctor, and had a second degree tear and repair. No loss of stool continence or pain but a question of loss of stool gases from the vagina. When I saw her four weeks ago, there was an area of weak support, like a dimple in the RV septum above the external sphincter ring, but I could not see a hole with probing the area. It was not inflamed or particularly tender. She did have a yeast infection, and that went away after treament, but the foul odor remained. I checked her today, and nothing had changed, other than finding a small amount of discharge over the dimple that smelled quite awful. Does anyone have experience with finding small fistulas? How about placing a tampon soaked with dye into the rectum and checking for dye in the vagina? Thanks. Dan Flaherty MD Watertown SD
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