J Korean Assoc Pediatr Surg.  2016 Dec;22(2):19-22. 10.13029/jkaps.2016.22.2.19.

Diagnosis and Treatment of Congenital H-type Rectovestibular Fistula

• Kim Y
• Kim M
• Lee S
• Seo JM
• Lee SK

• KMID: 2363018
• DOI: http://doi.org/10.13029/jkaps.2016.22.2.19

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.

Keyword

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

MeSH Terms

Abscess
Anal Canal
Congenital Abnormalities
Defecation
Diagnosis*
Fistula*
Humans
Inflammation
Postoperative Complications
Recurrence

Figure

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  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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