Journal List > J Korean Assoc Pediatr Surg > v.22(2) > 1071966

J Korean Assoc Pediatr Surg. 2016 Dec;22(2):19-22. Korean.
Published online December 22, 2016.  https://doi.org/10.13029/jkaps.2016.22.2.19
Copyright © 2016 by the Korean Association of Pediatric Surgeons
Diagnosis and Treatment of Congenital H-type Rectovestibular Fistula
Younjung Kim, Minjung Kim, Sanghoon Lee, Jeong-Meen Seo, and Suk-Koo Lee
Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Correspondence: Jeong-Meen Seo, Division of Pediatric Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea. Tel: +82-2-3410-0282, Fax: +82-2-3410-0040, Email: jm0815.seo@samsung.com
Received May 31, 2016; Revised July 02, 2016; Accepted July 21, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

The congenital H-type rectovestibular fistula, a fistula between the anorectum and genital tract besides a normal anus is a rare variant of anorectal deformities. This disease needs proper treatment but there are no standard of diagnosis and treatment. The purpose of this report is to review a 13-year experience of approach and management for H-type rectovestibular fistula at a single institution.

Methods

From February 2002 to August 2015, we cared for 11 patients who had congenital H-type rectovestibular fistula and reviewed their clinical presentation, accompanied anomalies, diagnostic modalities, operative technique, and postoperative progress.

Results

Most patients with H-type rectovestibular fistula presented with symptoms including vestibular defecation and major labial abscess. We could find the fistula tract in most of patients by fistulography using contrast dye. All of the patients had been operated. There were 2 recurrences after surgical treatment who had inflammation and infection associated with the fistula. All other patients recovered without complications.

Conclusion

We think the operation including fistulectomy and repair of perineal body through a transanal approach can be a feasible option to the congenital H-type rectovestibular fistula. Also, combined inflammation and infection should be treated prior to surgery to reduce postoperative complications.

Keywords: Anorectal malformation; H-type; Labium major abscess; Fistulectomy

Figures


Fig. 1
Surgical treatment of H-type rectovestibular fistula. (A) Fistulectomy following the fistula tract confirmed by probe. (B) Repair of perineal body by ligation and suture.
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Fig. 2
Staged treatment of H-type rectovestibular fistula combined with major labial abscess.
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Tables


Table 1
Diagnosis and Treatment of H-type Rectovestibular Fistula
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Notes

CONFLICTS OF INTEREST:No potential conflict of interest relevant to this article was reported.

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