The Role of History and Physical Examination in Colovaginal Fistula Diagnosis: A Case Report

Colovaginal fistula often presents subtly but can be diagnosed through careful history and physical examination making it a key condition for clinicians to recognize in older adults with a previous hysterectomy. In this case, a 79-year-old woman with a past medical history of Cesarean-section and hysterectomy presented to her primary care physician with a sensation of fluid in the abdomen, foul-smelling discharge, and vaginal flatus persisting for several weeks. Based on the history and physical exam, the patient received timely low anterior resection of a colovaginal fistulous connection. Colovaginal fistula can present with non-specific symptoms that can be diagnosed through careful history and physical examination leading to early intervention and quality of life preserving care.