To the Editor.—
In the QUESTIONS AND ANSWERS section (236:1289, 1976), Dr Taylor explained that the causes of the gas expulsion from the vagina are emphysematous vaginalis vaginitis or accumulation of air in the vagina following intercourse. In reviewing the literature, Wychulis and Pratt1 reported two patients in the analysis of 37 cases of sigmoidovaginal fistulas whose presenting symptom was solely "flatus vaginalis." In their study, the fistula occurred in these women when they were as young as 23 years of age. Therefore, the 26-year-old patient in question should be examined for the possibility of a fistula.The barium enema study may not be able to demonstrate a small fistulous tract. In such instance, vaginography is a successful diagnostic tool and the procedure is easy to perform.2-5 Although this patient has had occasional episodes of gas expulsion from the vagina, I expect that the knee-chest position will make
Adachi A. Expulsion of Gas From Vagina. JAMA. 1977;237(14):1435. doi:10.1001/jama.1977.03270410035012
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