ABSTRACT
Uterocutaneous fistula is a rare complication that may follow caesarean section. Herein is described a rare case of uterocutaneous fistula. The 35-year-old P3 L3 female patient presented to general surgery OPD with complaints of bleeding from sinus near the caesarean section scar site for last 2 years. She underwent three caesarean sections in the past. Laparotomy was performed. Conservative surgical treatment was successful. At 6-month follow-up, hysteroscopy revealed a normal uterine cavity. We conclude that conservative surgical treatment can be an efficient procedure.
ABSTRACT
A 44-year-old multipara presented with continuous urinary leakage per vagina of 15 months duration despite abdominal vesicovaginal fistula repair. Intravenous urography revealed normal upper urinary tract. Methylene blue test was positive but no fistula was detected on cystoscopy. Failure to cystoscopically visualize the catheter, which was easily introduced through the vaginal end of fistulous tract warranted a fistulogram that simulated retrograde ureteropyelogram and showed contrast in the bladder confirming ureterovesicovaginal fistula. Patient underwent transvesical ureteroneocystostomy with closure of bladder communication and remains continent at six months follow-up. Recurrence of urovaginal fistulae after vesicovaginal fistula repair may be attributable to undiagnosed ureteral involvement despite normal upper tract imaging. Simple procedures like cystoscopic visualization of catheter along with fistulogram can clinch the diagnosis in such cases.
ABSTRACT
Infection of the anal glands is the most common cause of anorectal abscess. Ductal obstruction may result in stasis, infection, and abscess formation. Drainage of the abscess through the perianal skin, whether spontaneous or operative, may lead to a fistula. the fistula in the fascial or fatty planes, especially within the intersphincteric space, located between the internal and the external sphincter extending into the ischiorectal fascia. Fistulas are usually divided into four main anatomic categories as described by Parks and colleagues in 1976.(1,2) The most commonly occurring is the intersphincteric fistula, constituting 70% of all anal fistulas. The infectious process starting from its origin passes directly downward to the anal margin, but there are some variants of these type of fistulas that are less common and more complex to treat. Transsphincteric (25%), suprasphincteric (4%), and extrasphincteric (1%) fistulas constitute the remaining 30% of other anal fistulas those are not intersphincteric. Extrasphincteric fistula is rare and difficult to treat. It begins from the perineal skin penetrating directly downward to the rectal wall above the levator ani. The tract it forms is completely outside the sphincteric apparatus. There are numerous causes to anal fistulas, including trauma, carcinoma, and Crohn's disease. We report a rare case of a 46 year old male patient with anal fistula which has a long abnormal course and an external opening in thigh. The patient suffered from pain on the external opening for 3 years, with dirty discharge.