title: Anovestibular fistula with normal anus.
abstract: OBJECTIVE
  The purpose of the study was to review a rare anomaly of anorectal malformations in girls, congenital anovestibular fistula (AVF) with normal anus, over a 12-year period.
  
  
  METHODS
  A total of 24 female patients of AVF with normal anus were treated in the Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh, from January 1994 to June 2006. Clinical features, operative findings, operative procedures, postoperative complications, and outcomes were analyzed.
  
  
  RESULTS
  Age ranged from 1 day to 7 years (mean, 10.5 months). All 24 female patients presented with passage of stools through 2 perineal openings. In addition, vulvar abscesses were noted in 5 cases. Vestibular opening of the fistula was found behind the vagina in 18 patients, and the anal opening of the fistula was on the anterior anal wall above the dentate line in 20 cases. There were no associated abnormalities. After adequate bowel preparation, 22 patients underwent excision of the fistulous tract with reconstruction of anal wall without a diverting colostomy. All 5 patients with vulvar abscess experienced wound disruption and required reoperation. All 24 girls have normal bowel motions at follow-up.
  
  
  CONCLUSIONS
  In the management of AVF with normal anus, primary repair without colostomy is a safe option. In cases of abscess or infection, definitive operation should be deferred until adequate healing is achieved.
authors: Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong 4000, Bangladesh. tahmina@pedsurgbd.org
authors: Tahmina
authors: T
authors: Banu
authors: Md Jafrul
authors: MJ
authors: Hannan
authors: Mozammel
authors: M
authors: Hoque
authors: M Abdul
authors: MA
authors: Aziz
authors: Kokila
authors: K
authors: Lakhoo
mesh_terms: D017677:Age Distribution; D001003:Anal Canal / Q000033:anatomy & histology*; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D019651:Plastic Surgery Procedures / Q000379:methods*; D012006:Rectovaginal Fistula / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome