Differential Diagnosis for Fecal Matter Coming from Vagina
Single Most Likely Diagnosis
- Rectovaginal Fistula: This condition, where there's an abnormal connection between the rectum and vagina, is the most direct explanation for fecal matter coming from the vagina. It can result from various causes such as childbirth, surgery, or disease.
Other Likely Diagnoses
- Vesicovaginal Fistula with Associated Rectal Injury: Although less common than a rectovaginal fistula, if there's an injury or fistula involving the rectum and a vesicovaginal fistula (an abnormal connection between the bladder and vagina), it could potentially lead to fecal matter in the vagina, especially if there's a complex pelvic injury.
- Crohn's Disease or Other Inflammatory Bowel Diseases: These conditions can cause fistulas between the intestine and vagina, leading to the passage of fecal matter through the vagina.
- Cancer (e.g., Rectal, Cervical, or Vaginal): Advanced cancers in the pelvic region can erode through tissues and create fistulas between the rectum and vagina.
Do Not Miss Diagnoses
- Diverticulitis with Fistula Formation: Although less common, diverticulitis (inflammation of a diverticulum in the digestive tract) can lead to fistula formation, including between the colon and vagina, which would be a serious condition requiring prompt treatment.
- Infectious Diseases (e.g., Tuberculosis, Actinomycosis): Certain infectious diseases can cause fistula formation or tissue destruction leading to abnormal connections between the rectum and vagina.
- Trauma: Severe pelvic trauma can result in fistulas between the rectum and vagina, which would need immediate medical attention.
Rare Diagnoses
- Congenital Anomalies: Rare congenital conditions can result in abnormal connections between the rectum and vagina, presenting with symptoms later in life.
- Foreign Body: The presence of a foreign body in the vagina or rectum could potentially cause erosion or fistula formation, although this would be an unusual cause.
- Lymphogranuloma Venereum or Other Sexually Transmitted Infections: Certain sexually transmitted infections can cause significant tissue destruction and potentially lead to fistula formation, although this is rare.