Presentation
Known long-standing case of Crohn disease with the passage of gas and stool from the vagina.
Patient Data
By injecting the contrast medium, a long segment of severe stricture is seen in the rectosigmoid, measured about 9 cm long. The contrast medium passes proximal to the stricture and fills the colon lumen. The colon is elongated, and the transverse colon ptosis is evident.
In addition, a rectovaginal fistulous formation is evident, and the contrast medium enters the vaginal canal.
Case Discussion
A rectovaginal fistulous formation and a long-segment rectosigmoid stricture, also known as string sign, in a patient with long-standing Crohn disease.
The string sign refers to the tubular narrowing of the bowel loop due to spasm or stricture, depending on the chronicity, and was originally used to be described in Crohn disease. However, it is now used for any severe narrowing of the bowel lumen, including that seen in hypertrophic pyloric stenosis, gastrointestinal tuberculosis, carcinoid tumor, and colon cancer.
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