Clinical signs and symptoms in a rectovaginal fistula:
(1) pelvic pain
(2) rectal and/or vaginal bleeding
(3) vaginal passage of gas
(4) vaginal passage of purulent or necrotic material
(5) vaginal passage of stool (or meconium in the neonate)
(6) clinical findings associated with the underlying condition
Predisposing conditions for rectovaginal fistula:
(1) obstetrical injury
(2) inflammatory bowel disease, especially Crohn's disease
(3) previous anorectal surgery
(4) anorectal or pelvic infection (tuberculosis, lymphogranuloma venereum, schistosomiasis, diverticulitis)
(5) anorectal or vaginal carcinoma
(6) pelvic radiation therapy
(7) trauma (which may include rape or anal intercourse)
(8) anorectal anomaly, often with imperforate anus (usually presenting in infants)
