{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T10:10:03Z","timestamp":1745748603837,"version":"3.40.4"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,1,30]]},"abstract":"<jats:p>Formation of a colonic J-pouch with anastomosis to the rectal stump is an accepted form of reconstruction after low anterior resection (LAR) for rectal carcinoma. It is thought this can help prevent the onset of LAR syndrome as well as improve the quality of life in the first two\u2009years following surgery. Rectovaginal fistulation is a recognised complication of this form of surgery usually occurring because of technical failure leading to inclusion of the vaginal wall into the stapled anastomosis. We present an as of yet unreported case of fistulation between the upper horizontal staple line of a colonic J-pouch\u2014the tip of the \u2018J\u2019\u2014which was formed extracorporeally with the posterior vaginal fornix. We postulate that pelvic irradiation was partly a causative factor alongside subsequent mechanical irritation. Ultimately, surgical intervention was required, following which the patient made a full recovery. Interposition of omentum may prevent this problem.<\/jats:p>","DOI":"10.1136\/bcr-2017-222251","type":"journal-article","created":{"date-parts":[[2018,2,16]],"date-time":"2018-02-16T15:35:36Z","timestamp":1518795336000},"page":"bcr-2017-222251","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Fistulation between a colonic J-Pouch and the upper vagina in an irradiated pelvis: a rare complication following low anterior resection with colonic J-pouch anal anastomosis for rectal cancer"],"prefix":"10.1136","volume":"2018","author":[{"given":"James","family":"Tankel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shlomo","family":"Yellinek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petachia","family":"Reissman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,2,16]]},"reference":[{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00384-006-0187-5","article-title":"A systematic review of the function and complications of colonic pouches","volume":"22","author":"Koh","year":"2007","journal-title":"Int J Colorectal Dis"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-012-0909-3"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.3","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/BF02483037","article-title":"Successful transvaginal repair of a rectovaginal fistula developing after double-stapled anastomosis in low anterior resection: report of four cases","volume":"29","author":"Nakagoe","year":"1999","journal-title":"Surg Today"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.4","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1007\/BF02048113","article-title":"Rectovaginal fistula: complication of low anterior resection","volume":"35","author":"Rex","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.5","first-page":"270","article-title":"The double-staple technique in colorectal anastomoses: a critical review","volume":"58","author":"Baran","year":"1992","journal-title":"Am Surg"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.6","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/(SICI)1096-9098(199602)61:2<155::AID-JSO12>3.0.CO;2-8","article-title":"Rectovaginal fistula following low circular stapled anastomosis in women with rectal cancer","volume":"61","author":"Sugarbaker","year":"1996","journal-title":"J Surg Oncol"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.7","doi-asserted-by":"crossref","first-page":"710","DOI":"10.9738\/INTSURG-D-13-00187.1","article-title":"Puborectal sling interposition combined with seton drainage for pouch-vaginal fistula after rectal cancer surgery with colonic J pouch-anal reconstruction: report of a case","volume":"99","author":"Kawamoto","year":"2014","journal-title":"Int Surg"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.8","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1007\/s00384-015-2340-5","article-title":"Incidence and risk factors for rectovaginal fistula after low anterior resection for rectal cancer","volume":"30","author":"Watanabe","year":"2015","journal-title":"Int J Colorectal Dis"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.9","doi-asserted-by":"crossref","first-page":"73123","DOI":"10.18632\/oncotarget.17046","article-title":"Rectovaginal fistula after low anterior resection in Chinese patients with colorectal cancer","volume":"8","author":"Zheng","year":"2017","journal-title":"Oncotarget"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2009.09.003"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.11","doi-asserted-by":"crossref","first-page":"096","DOI":"10.1055\/s-2007-977487","article-title":"Rectovaginal fistulas: current surgical management","volume":"20","author":"Rivadeneira","year":"2007","journal-title":"Clin Colon Rectal Surg"},{"key":"2025042702523051000_2018.feb16_1.bcr-2017-222251.12","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/00000658-199102000-00010","article-title":"Transvaginal approach for repair of rectovaginal fistulae complicating Crohn\u2019s disease","volume":"213","author":"Bauer","year":"1991","journal-title":"Ann Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T09:52:39Z","timestamp":1745747559000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,16]]},"references-count":12,"alternative-id":["10.1136\/bcr-2017-222251"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222251","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,2,16]]}}}