Peritoneal vaginal fistula and contrast extravasation during MRI

Esraa Al-Jabbari, Neel Shroff, Hasan Khan, Maryamnaz Falamaki, Peeyush Bhargava

Research output: Contribution to journalArticlepeer-review


Gynecological malignancies including primary cervical cancers are frequently treated with chemotherapy and radiation. Fistulas affecting the gynecological organs and surrounding cavities are a known consequence of radiotherapy due to focal necrosis of the regional mucosa. In this report, we will demonstrate a rare case of a posterior vaginal wall rupture with resulting fistulization into the peritoneal cavity in a 50-year-old female patient with squamous cell carcinoma of the cervix status postchemoradiotherapy. Magnetic resonance imaging (MRI) showed a discontinuity in the posterior vaginal wall near the fornix with extravasation of ultrasound gel used as contrast into the intraperitoneal compartment. Patient later presented with peritonitis like signs and symptoms and was treated successfully with antibiotics. Vaginal gel should be used with caution in patients with prior history of radiation due to the possibility of vaginal rupture which may lead to peritoneal vaginal fistula and contrast extravasation.

Original languageEnglish (US)
Pages (from-to)3731-3734
Number of pages4
JournalRadiology Case Reports
Issue number10
StatePublished - Oct 2022


  • Fistula
  • MRI
  • Peritoneum
  • Ultrasound gel
  • Vagina

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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