OB-GYN-L Messages for March, 2008: Re: Entero-vaginal fistula

Re: Entero-vaginal fistula

From: FRANCES WREN

fwren@shaw.ca

Thu Mar 6 10:09:18 2008

I have seen a couple of patients over my career with croh'n disese producing what looked like enerovag fistulas.. one was operated on twice by a colleague as a bartholins..which by the third time I was lucky enough to see and realize it was a fistula...and not a bartholins ( though probably I would too have missed it at first) also if it is small and recent sometimes a long period of oral flgayl will cure it...at least it did in the second one .ie cure the fistula which was tiny...not the crohn's frances wren

>----- Original Message -----
From: dr99645@yahoo.com (D. Glen Elrod, MD) Date: Wednesday, March 5, 2008 3:28 pm Subject: Re: Entero-vaginal fistula To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net>

> Rafael,
>
> Have you seen this patient yet? I have this exact patient coming
> to see
> me tomorrow. I'm curious if anything that was listed
> actually worked on
> this patient.
>
> Mine has known diverticular disease as her risk factor for her
> fistula.
> Glen
>
> At Wed, 20 Feb 2008, Raymond Stephen wrote:
> >
> >First question should be, what in the history could have caused a
> >fistula? They don't arise spontaneously. Then look
> for the hole. If
> >you don't see it, the "gas" is probably entrapped air. If
> you still
> >think there is a hole even though you haven't seen it, then an
> EUA with
> >a finger stretching the rectovaginal septum from the rectal side.
> >Usually the fistulous tract is scarred and contracted and that
> deformity>can be felt even if not seen.
> >
> >Steve
> >
> >________________________________
> >
> >________________________________
> >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf
> Of Rafael
> >
> >--
> >________________________________
> >Haciski
> >________________________________
> >Sent: Wednesday, 20 February 2008 3:28 AM
> >To: Multiple recipients of list OB-GYN-L
> >Subject: Entero-vaginal fistula
> >
> >I am having a pt referred to me for evaluation of "passing gas per
> >vagina"
> >
> >Not having seen a fistula since residency days, I am looking
> for advice
> >on which diagnostic modalities may be best suited to confirming
> such a
> >fistula (beyond the physical exam at which time one may see the
> actual>fistula, stool etc)., to delineate it's source, course etc.
> >
> >Rafael Haciski MD FACOG
> >
> >Anchor Health Centers GYN
> >
> >800 Goodlette Rd #360
> >
> >239-643-8780 office
> >
> >239-571-0292 cell
> >
> >Naples, FL.
> >
> >CONFIDENTIALITY NOTICE AND DISCLAIMER
> >
> >The information in this transmission may be confidential and/or
> protected by legal professional privilege, and is intended only
> for the person or persons to whom it is addressed. If you are
> not such a person, you are warned that any disclosure, copying
> or dissemination of the information is unauthorised. If you have
> received the transmission in error, please immediately contact
> this office by telephone, fax or email, to inform us of the
> error and to enable arrangements to be made for the destruction
> of the transmission, or its return at our cost. No liability is
> accepted for any unauthorised use of the information contained
> in this transmission. If the transmission contains advice, the
> advice is based on instructions in relation to, and is provided
> to the addressee in connection with, the matter mentioned above.
> Responsibility is not accepted for reliance upon it by any other
> person or for any other purpose.
> >
>

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<DIV>I have seen a couple of patients over my career with croh'n disese producing what looked like enerovag fistulas..</DIV> <DIV>one was  operated on twice by a colleague as a bartholins..which by the third time I was lucky enough to see and realize it was a fistula...and not a bartholins ( though probably I would too have missed it at first)</DIV> <DIV>also if it is small and recent sometimes a long period of oral flgayl will cure it...at least it did in the second one .ie cure the fistula which was tiny...not the crohn's</DIV>

><DIV>frances wren ----- Original Message ----- From: dr99645@yahoo.com (D. Glen Elrod, MD) Date: Wednesday, March 5, 2008 3:28 pm Subject: Re: Entero-vaginal fistula To: Multiple recipients of list OB-GYN-L <ob-gyn-l@mail.obgyn.net> > Rafael, > > Have you seen this patient yet? I have this exact patient coming > to see > me tomorrow.  I'm curious if anything that was listed > actually worked on > this patient. > > Mine has known diverticular disease as her risk factor for her > fistula. > Glen > > At Wed, 20 Feb 2008, Raymond Stephen wrote: > > > >First question should be, what in the history could have caused a > >fistula?  They don't arise spontaneously.  Then look > for the hole.  If > >you don't see it, the "gas" is probably entrapped air.  If > you still > >think there is a hole even though you haven't seen it, then an > EUA with > >a finger stretching the rectovaginal septum from the rectal side. > &
gt;Usually the fistulous tract is scarred and contracted and that > deformity>can be felt even if not seen. > > > >Steve > > > >________________________________ > > > >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf > Of Rafael > > > >-- > >________________________________ > >Haciski > >Sent: Wednesday, 20 February 2008 3:28 AM > >To: Multiple recipients of list OB-GYN-L > >Subject: Entero-vaginal fistula > > > >I am having a pt referred to me for evaluation of "passing gas per > >vagina" > > > >Not having seen a fistula since residency days, I am looking > for advice > >on which diagnostic modalities may be best suited to confirming > such a > >fistula (beyond the physical exam at which time one may see the > actual>fistula, stool etc)., to delineate it's source, course etc. > > > >Rafael Haciski  MD FACOG > > > >Anchor Health Centers GYN > > > >800 Goodlette Rd #360 > > > >239-643-8780 office > > > >239-571-0292 cell > > > >Naples, FL. > > > >CONFIDENTIALITY NOTICE AND DISCLAIMER > > > >The information in this transmission may be confidential and/or > protected by legal professional privilege, and is intended only > for the person or persons to whom it is addressed. If you are > not such a person, you are warned that any disclosure, copying > or dissemination of the information is unauthorised. If you have > received the transmission in error, please immediately contact > this office by telephone, fax or email, to inform us of the > error and to enable arrangements to be made for the destruction > of the transmission, or its return at our cost. No liability is > accepted for any unauthorised use of the information contained & #060;BR>> in this transmission. If the transmission contains advice, the > advice is based on instructions in relation to, and is provided > to the addressee in connection with, the matter mentioned above. > Responsibility is not accepted for reliance upon it by any other > person or for any other purpose. > > > > </DIV>

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