Pitfall in the One-stage Management of Rectovestibular Fistula: A Rare Variant of Congenital Pouch Colon.

The gold standard for management of rectovestibular fistula is a three-stage procedure in many Western countries. This malformation has been corrected successfully in a single-stage in the Indian subcontinent. This report describes a girl with rectovestibular fistula who was later diagnosed to be a case of congenital pouch colon (CPC).

Tubular Colonic Duplication Presenting as Rectovestibular Fistula / 대한소아소화기영양학회지

Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in about 15% of all gastrointestinal duplications. Double termination of tubular colonic duplication in the perineum is even more uncommon. We present a case of a Y-shaped tubular colonic duplication which presented with a rectovestibular fistula and a normal anus. Radiological evaluation and initial exploration for sigmoidostomy revealed duplicated colons with a common vascular supply. Endorectal mucosal resection of theduplicated distal segment till the colostomy site with division of the septum of the proximal segment and colostomy closure proved curative without compromise of the continence mechanism. Tubular colonic duplication should always be ruled out when a diagnosis of perineal canal is considered in cases of vestibular fistula alongwith a normal anus.

Infantile Vulvar Abscess with a Normal Anus: A Suspicious Sign of Rectovestibular Fistula

PURPOSE: We investigated whether infantile vulvar abscesses are predictable features of rectovestibular fistula with a normal anus. MATERIALS AND METHODS: A retrospective analysis of five infants with vulvar abscesses and rectovestibular fistulae with normal anuses was performed. RESULTS: Four cases had a left vulvar abscess, and in one case the vulvar abscess was on the right side. All caregivers reported passage of stool from the vagina. The fistulae were almost uniformly located from the vestibule to the rectum above the anal dentate line, observable by visual inspection and probing under anesthesia. The first two cases were treated with division and closure of the fistulae after a diverting loop colostomy, and the remaining three cases with fistulotomy and curettage. There was no recurrence during the median follow-up period of 38 months. CONCLUSION: This unique rectovestibular fistula should be suspected in female infants with vulvar abscesses, especially when parents report passage of stool from the vagina. Fistulotomy and curettage may be an initial treatment and effective as a temporary diverting colostomy and delayed repair of the fistula.

Anterior sagittal anorectoplasty for imperforate anus with rectovestibular fistula / 中国普通外科杂志

ObjectiveTo evaluate the effects of anterior sagittal anorectoplasty(ASARP) on treating imperforate anus with rectovestibular fistula(IAFR).MethodsThe clinical data of 16 cases of IAFR treated by ASARP were analysed retrospectively.ResultsSixteen cases were followed-up for 2 months to 5 years.The anus function was assessed according to the Clinical Scoring Systems of LI Zheng.Excellent scores were obtained in 13 cases and good in 3 cases;1 patient suffered from incision infection postoperatively.ConclusionsASARP is a feasible therapy for imperforate anus with IAFR.