Late failure of a stapled small-bowel exclusion procedure

Late failure of a stapled small-bowel exclusion without transection of the bowel resulted in recurrence of an enterovaginal fistula. This necessitated reoperation and division of the small bowel, following which the patient has remained well. A review of the literature indicates that this problem might occur in similar procedures and suggests that the bowel should not only be cross stapled, but transected when performing exclusion procedures.