A Case of Low Rectovaginal Fistula of Obstetric Origin: Treatment by Fistulotomy and Reconstitution or Advancement Flap?

Frontiers in Surgery
Elroy Patrick WeledjiDivine Enoru Eyongeta

Abstract

Many small low rectovaginal fistulas represent incompletely healed (third degree) perineal lacerations i. e., involving the sphincters. An individualized, systematic approach to these fistulas based on their size, location, and etiology provides a more concise treatment plan. We report a case of a low rectovaginal fistula developed some years following forceps vaginal delivery. This was managed successfully by a fistulotomy in which the bridge of skin and scar tissue was divided, and the defect repaired as a classical third degree perineal laceration. On the background of coexisting or occult sphincter damage which usually follows obstetric trauma, a fistulotomy and immediate composite repair for small, low rectovaginal fistula may be advantageous and acceptable in a low resource setting where endoanal imaging and manometry are not available.

References

Apr 1, 1973·The Journal of Obstetrics and Gynaecology of the British Commonwealth·R J Bentley
Apr 1, 1994·Diseases of the Colon and Rectum·K S KhandujaR F Hartmann
Sep 28, 1998·Diseases of the Colon and Rectum·C B TsangA C Lowry
Jun 18, 2002·Diseases of the Colon and Rectum·Amy L Halverson, Tracy L Hull
May 31, 2014·Journal of Surgical Case Reports·Elroy P WeledjiVincent Verla
Mar 2, 2016·Clinics in Colon and Rectal Surgery·Bidhan Das, Michael Snyder
Oct 21, 2018·International Journal of Surgery·Riaz A AghaUNKNOWN SCARE Group

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Citations

Sep 16, 2020·International Urogynecology Journal·Joanna C RoperAbdul H Sultan

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