Delayed presentation of a congenital recto-vaginal fistula associated with a recto-sigmoid tubular duplication and spinal cord and vertebral anomalies.
Tubular duplication of the recto-sigmoid colon is a rare entity. Associated anomalies including fistulae to the genitourinary tract may be found. A baby girl was found to have duplication of the recto-sigmoid colon, anomalies of sacral vertebra from S1 to S5, and solitary right kidney. The septum of this duplication was divided using staplers. Because of a history of stool coming from the vagina, a meticulous examination perioperatively was performed, but no fistula could be found. Further extensive investigation failed to show any fistula. At the age of 10 she was operated on for a tethered cord. At age 14, she experienced passage of a small amount of liquid stool per vaginum. A recto-vaginal fistula was found. Via a posterior sagittal incision, the fistula was closed by a transrectal approach. She remained asymptomatic for 16 months until the fistula recurred. Using a perineal approach, a very short fistula between the vagina and the rectum was closed. The closure was reinforced by a vaginal flap. Four months later, she remains without signs of recurrence.
Prasil
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Division of Pediatric General Surgery, The Montreal Children's Hospital, McGill University Health Centre, Quebec, Canada.
Nguyen
L T
LT
Laberge
J M
JM
D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000601:surgery; D012809:Colon, Sigmoid / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011859:Radiography; D012006:Rectovaginal Fistula / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D012007:Rectum / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D012008:Recurrence; D012447:Sacrum / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013116:Spinal Cord / Q000002:abnormalities* / Q000000981:diagnostic imaging; D016896:Treatment Outcome