Pouchogram in a 49-year old female who presented with feculent vaginal discharge, with a prior history of ileal pouch-anal anastomosis surgery for UC. Sinus Tract (arrow) arising from the superior aspect of the anus, extending anteriorly just below the level of the ileo-anal anastomosis. Approximately 1 cm inferior to the sinus tract is a fistula (arrowhead) which extends to the mid-vagina and results in filling of the vaginal vault.