The article describes clinical case of a patient with two rectovaginal fistulas of high and low level. The first stage included diverting loop sigmostomia and latex seton for low fistula. Three months later, on the second stage, fistulectomy with invagination of the fistula to rectal lumen with compression of invaginated part by titanium nickelide clamp was done. The fistulectomy with sphincteroplasty was done for the lower fistula. No postoperative complications developed; the complete recovery was detected. Seven months later, on the third stage, the stoma closure was done. No complications and fistula recurrence were obtained in 2 months of follow-up.

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The foreign and domestic literature analysis was conducted in PubMed, Google schoolar and eLibrary databases, considered tactical aspects of the surgical treatment of colorectal cancer complicated with acute large bowel obstruction. The results of different surgical techniques by acute large bowel obstruction were compared. There is still high rate of post-operative complications and morbidity non-depending on the chosen techniques. The problem of colorectal cancer treatment complicated with large bowel obstruction needs further studies and careful examinations. Using prognostic scales for patient stratifications seems to be prospective as the tactic optimization and therefore might be useful for choosing an optimal way of surgical treatment for acute large bowel obstruction.