Martius flap reconstruction for rectovaginal fistula after stapled hemorrhoidopexy (Longo operation): a case report

International Journal of Colorectal Disease
Ellen LiekensYves Pirenne

Abstract

A rectovaginal fistula (RVF) is a rare disease. It's an epithelium-lined abnormal communication between rectum and vagina. It represents approximately 5% of all anorectal fistulas. RVF may have different causes. We present a case of a 58-year-old woman with a rectovaginal fistula after stapled hemorrhoidopexy (Longo operation). A 58-year-old woman presented herself in our department with vaginal fecal discharge and vaginitis almost one month after a stapled hemorrhoidopexy was performed in another hospital. On vaginal examination, a large dorsal defect was palpated at four cm. On rectal examination, the stapler line was palpable at four cm and just distal to this stapler line, a large defect could be palpated. A lower gastrointestinal tract radiography was performed and identified a RVF. The patient was put on antibiotics and two operations were planned. First, a temporary ileostomy was created. After healing of the vaginitis, reconstructive surgery with anatomic fistula repair in combination with the interposition of healthy, vascularised tissue was performed. In this case, we chose the Martius flap. The operation as well as the postoperative course was uneventful. Cases of postoperative RVF have been increasingly reported sin...Continue Reading

References

Nov 5, 2014·Geburtshilfe und Frauenheilkunde·M ReichertW Padberg
Sep 4, 2015·World Journal of Gastrointestinal Surgery·Kevin R KnieryScott R Steele
Mar 2, 2016·Clinics in Colon and Rectal Surgery·Bidhan Das, Michael Snyder

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Citations

Aug 21, 2021·Annals of the Royal College of Surgeons of England·P WangQ Wang

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