Intra vaginal wooden foreign body causing multiple internal fistulae and bladder stone in a 12 years girl

ABSTRACT

Vaginal foreign bodies in girls may be accidental, self-inflicted or secondary to child abuse. These may causes a number of complications like Infections, abscess formation, intestinal perforation, vaginal discharge and internal fistulae. We are presenting a case of a 13 years old girl who presented with a supra-pubic mass and dysuria. X-ray showed a radio-opaque shadow in pelvis. The child was admitted in medical ward with the diagnosis of bladder stone and UTI. She was pouring frank pus from the vagina. On rectal digital examination a hard foreign body was felt in the rectum. Investigations revealed that she had a large pelvic collection, a sharp wooden Foreign Body [FB] extending from the rectum through the vagina in to the urinary bladder forming a bladder stone. Patient also developed recto-vaginal and vesico-vaginal fistulae. Foreign body was removed along with the bladder stone, pelvic abscess drained and colostomy was performed. Later repair of vesico-vaginal fistula were performed, recto-vaginal fistula closed spontaneously and colostomy closed. Patient became fully continent for urine and feces after completion of surgical procedures. A careful history from the child revealed that she had inserted the foreign body herself as a self-exploring practice