scholarly journals Rectoperineal Fistula Presented 5 Months After Repair of Severe Obstetric Perineal Laceration: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Yusuke Ohara ◽  
Tsuyoshi Enomoto ◽  
Yohei Owada ◽  
Katsuji Hisakura ◽  
Yoshimasa Akashi ◽  
...  
Keyword(s):  
Primary Repair ◽  
Fistulous Tract ◽  
Layer By Layer ◽  
Perineal Laceration ◽  
Fistula Closure ◽  
Perineal Approach ◽  
Fourth Degree ◽  
Case Presentation ◽  
Sphincter Function ◽  
Anal Sphincter Function

Introduction: Obstetric severe perineal laceration can frequently occur as a surgical site infection (SSI), which sometimes leads to rectovaginal fistula after repair. We encountered a rare case of a rectoperineal fistula 5 months after repair of a severe perineal laceration.Case presentation: The patient was a 39-year-old woman who underwent repair of a fourth-degree perineal laceration after vaginal delivery. Five months after primary repair, she presented with perineal swelling and pain followed by uncontrollable flatulence or passage of feces at the perineum, which was finally diagnosed as a rectoperineal fistula. Transperineal repair with fistulous tract excision was performed for the rectoperineal fistula. Closure of the rectum, perineal body, and vagina was performed layer-by-layer constructing a thick perineum to prevent anal dysfunction. The fistula was successfully closed, and the patient did not show any symptoms of fecal incontinence 6 months after surgery.Discussion: As the rectoperineal fistula might have resulted in SSI at the primary repair of the obstetric injury, the delayed occurrence of the rectoperineal fistula was unusual. A perineal approach should be performed for complete fistulous tract excision, reconstruction of a robust perineal structure, and preservation of anal sphincter function.

Anal sphincter function and integrity after primary repair of third‐degree tear: uncontrolled prospective analysis

2004 ◽  
Vol 74 (3) ◽  
pp. 122-124 ◽  
Author(s):  
Nicholas Rieger ◽  
Shevy Perera ◽  
Jacque Stephens ◽  
Donna Coates ◽  
Darren Po
Keyword(s):  
Anal Sphincter ◽  
Primary Repair ◽  
Prospective Analysis ◽  
Sphincter Function ◽  
Anal Sphincter Function

scholarly journals Laparoscopic Repair of a Post-myomectomy Uterocutaneous Fistula in a Nulligravida: A Case Report

2021 ◽  
Vol 9 (3) ◽  
pp. 222-224
Author(s):  
Ashwin Rao ◽  
Saravanan Nanjappan
Keyword(s):  
Abdominal Pain ◽  
Cesarean Section ◽  
Laparoscopic Resection ◽  
Fistulous Tract ◽  
Successful Outcome ◽  
Layer By Layer ◽  
Gynecological Surgery ◽  
Fistula Repair ◽  
Case Presentation ◽  
Nulliparous Women

Introduction: An abnormal passage connecting the skin and the uterus is the uterocutaneous fistula. It is rarely observed after a cesarean section or a gynecological surgery involving the uterus. The presence of an infection further complicates the management. In countries such as India where tuberculosis is highly prevalent, Mycobacterium tuberculosis should be ruled out. Case Presentation: A 29-year-old nulliparous woman who had undergone a laparotomy for removal of a large fibroid for primary infertility presented with complaints of abdominal pain and discharge from the scar site. These symptoms did not resolve with antibiotics and analgesics. An ultrasonography was performed and a fistulous tract extending up to the endometrium was revealed. She underwent a laparoscopic resection of the fistulous tract following which she was symptom free. Conclusion: One of the rarely observed complications following laparotomies and cesarean section is a uterocutaneous fistula. It is even rarer in women with no previous pregnancies. The management involves adhesiolysis and layer by layer closure of the uterus and abdomen wall after excising the tract. Most often a repeat laparotomy is performed to treat the condition, but in the current times it is well known that repeated open surgeries in the peritoneal cavity increase the chances of adhesions which can reduce the chances of pregnancies in nulliparous women. Hence, this article shows a successful outcome of laparoscopic uterocutaneous fistula repair.

CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

2020 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Clinical Symptoms ◽  
Hirschsprung Disease ◽  
Distal Colon ◽  
Total Colonic Aganglionosis ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
History Of ◽  
High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

Traditional measures of normal anal sphincter function using high-resolution anorectal manometry (HRAM) in 115 healthy volunteers

2014 ◽  
Vol 26 (5) ◽  
pp. 625-635 ◽  
Author(s):  
E. V. Carrington ◽  
A. Brokjaer ◽  
H. Craven ◽  
N. Zarate ◽  
E. J. Horrocks ◽  
...  
Keyword(s):  
High Resolution ◽  
Healthy Volunteers ◽  
Anal Sphincter ◽  
Anorectal Manometry ◽  
Sphincter Function ◽  
Anal Sphincter Function

scholarly journals Tubocutaneous Fistula

2015 ◽  
Vol 2015 ◽  
pp. 1-2
Author(s):  
Krishnaveni Nayini ◽  
Clive Gie
Keyword(s):  
Early Diagnosis ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Fistulous Tract ◽  
Rare Condition ◽  
Diagnosis And Treatment ◽  
Case Presentation ◽  
Child Birth ◽  
The Right

Introduction. Tubocutaneous fistula is a very rare condition; most cases described in the literature are secondary to endometriosis, tuberculosis, and complications of child birth and gynecological operations.Case Presentation. We report a case of 40-year-old woman who presented with tubocutaneous fistula secondary to pelvic inflammatory disease which was diagnosed in the setting of persistent discharging wound in the right groin.Conclusion. Tubocutaneous fistula is a rare condition. Salpingectomy and resection of fistulous tract is the treatment of choice as is treating the underlying cause. Early diagnosis and treatment of these patients are essential for avoiding long term complications.

The Effects of Age and Childbirth on Anal Sphincter Function and Morphology in 999 Symptomatic Female Patients With Colorectal Dysfunction

2012 ◽  
Vol 55 (3) ◽  
pp. 286-293 ◽  
Author(s):  
D. J. Boyle ◽  
C. H. Knowles ◽  
J. Murphy ◽  
C. Bhan ◽  
N. S. Williams ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Female Patients

scholarly journals A comparative study in the management of fistula in ANO using various modalities

2018 ◽  
Vol 5 (6) ◽  
pp. 2223 ◽  
Author(s):  
Ramachandra M. L. ◽  
Mayank Garg
Keyword(s):  
Fistulous Tract ◽  
Selection Method ◽  
Fistula Tract ◽  
Internal Opening ◽  
Necrotic Tissue ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Medical College ◽  
Operative Complications ◽  
Comparative Prospective Study

Background: Fistula in ano is a track that connects deeply the anal canal or rectum to the skin around the anus. Fistula in ano most commonly follows an anorectal sepsis1. The main principles of management of anal fistula are closure of internal opening of fistula tract, drainage of infection or necrotic tissue, and eradication of fistulous tract with preservation of sphincter function. The objectives were to compare the various aspects like per operative complications, post-operative complications, mean hospital stay in the treatment of fistula in ano using various modalities like fistulotomy, fistulectomy, setons and lift procedure.Methods: This is a randomised, comparative, prospective study of 80 cases of fistula in ano, presenting at surgical opd of K.R. Hospital, Mysore attached to Mysore Medical College and research Institute. Out of which, 20 cases are treated by fistulectomy, 20 by seton, 20 by fistulotomy and the rest 20 cases by LIFT procedure by random selection method, during period of NOVEMBER 1, 2016 to 31st October 2017.Results: Most common age of presentation is 31-40 years and more common in males then females (M:F= 2.3:1 ). Per operative complications include bleeding seen more in patients undergoing fistulectomy. Per operative course of LIFT procedure patients was complication free. Postoperative pain seen more in patients undergoing setons procedure.Conclusions: we conclude that LIFT procedure and Fistulotomy were acceptable procedures for simple, uncomplicated low lying and high lying fistula.

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