Main Article Content
Abstract
ABSTRACT
Recto-vaginal fistula (RVF) is defined as an abnormal communication between the rectum and vagina across the recto-vaginal septum. We present the case of a 51-year-old female patient, G6P5014, with a 12-year history of stool and gas emissions through the vagina, following vaginal delivery of a 5010 gr newborn complicated by a 4th degree perineal tear. Three months later, a recto-vaginal fistula had been diagnosed followed by failed repair. Identified with a recurrent supra-sphincteric recto-vaginal fistula, the patient underwent a new repair of the fistula with favorable results. It is important to achieve tension-free closure of the various mucous membranes.
RÉSUMÉ
La fistule recto-vaginale est une communication anormale entre le vagin et le rectum à travers la paroi recto-vaginale. Nous présentons le cas d'une patiente de 51 ans, G6P5014, avec une histoire d'émissions de selles et de gaz par le vagin évoluant depuis 12 ans, à la suite d'un accouchement d'un nouveau-né de 5010 gr par voie vaginal compliqué par une déchirure périnéale du 4e degré. Trois mois après, une fistule recto-vaginale avait été diagnostiquée suivie d'un échec de réparation. Le diagnostic de fistule supra-sphinctérienne recto-vaginale récurrente posé, la patiente a subi une nouvelle réparation de la fistule avec des suites favorables. Il est important de réaliser une fermeture sans tension des différentes muqueuses.
Keywords
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References
- Manaouil D, Dumont F, Regimbeau JM, Duval H, Brazier F, Dupas JL, et al. Fistules rectovaginales acquises de l’adulte. Gastroentérologie Clinique et Biologique. 1 déc 2004;28(12):1267‑79.
- Ngaroua D, Aïssatou A, Dah’Ngwa D, Djibrilla Y, Ngah JE. Clinical Features and Management of Obstetric Fistula at the Protestant Hospital of Ngaoundéré (Cameroon). HEALTH SCIENCES AND DISEASE [Internet]. 2019 [cité 28 oct 2024];20(1). Disponible sur: http://hsd-fmsb.org/index.php/hsd/article/view/1112
- Drusany Starič K, Distefano REC, Campo G, Norčič G. Delayed surgical management of rectovaginal fistula: a case report highlighting challenges and lessons learned. Front Surg. 2023;10:1260355.
- Falih Noori I. Rectovaginal fistulas, outcomes of various surgical repair and predictive factors of healing success. A retrospective cohort study of 40 cases. International Journal of Surgery Open. 1 mai 2021;32:100335.
- Das B, Snyder M. Rectovaginal Fistulae. Clinics in Colon and Rectal Surgery. mars 2016;29(1):50.
- Beksac K, Tanacan A, Ozgul N, Beksac MS. Treatment of Rectovaginal Fistula Using Sphincteroplasty and Fistulectomy. Obstetrics and Gynecology International. 6 mai 2018;2018:5298214.
- Pollaczek L, Rajagopal K, Chu J. Patient characteristics, surgery outcomes, presumed aetiology and other characteristics of fistula surgeries and related procedures supported by Fistula Foundation from 2019 to 2021: a multicentre, retrospective observational study. BMJ Open. 13 mars 2024;14(3):e078426.
- Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study | BMC Women’s Health | Full Text [Internet]. [cité 17 oct 2024]. Disponible sur: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01866-z
- Dawes AJ, Jensen CC. Rectovaginal Fistulas Secondary to Obstetrical Injury. Clin Colon Rectal Surg. janv 2021;34(1):28‑39.
- Kniery KR, Johnson EK, Steele SR. Operative considerations for rectovaginal fistulas. World Journal of Gastrointestinal Surgery. 27 août 2015;7(8):133.
- Bhome R, Monga A, Nugent KP. A transvaginal approach to rectovaginal fistulae for the colorectal surgeon: technical notes and case series. Techniques in Coloproctology. 30 mars 2018;22(4):305.
References
Manaouil D, Dumont F, Regimbeau JM, Duval H, Brazier F, Dupas JL, et al. Fistules rectovaginales acquises de l’adulte. Gastroentérologie Clinique et Biologique. 1 déc 2004;28(12):1267‑79.
Ngaroua D, Aïssatou A, Dah’Ngwa D, Djibrilla Y, Ngah JE. Clinical Features and Management of Obstetric Fistula at the Protestant Hospital of Ngaoundéré (Cameroon). HEALTH SCIENCES AND DISEASE [Internet]. 2019 [cité 28 oct 2024];20(1). Disponible sur: http://hsd-fmsb.org/index.php/hsd/article/view/1112
Drusany Starič K, Distefano REC, Campo G, Norčič G. Delayed surgical management of rectovaginal fistula: a case report highlighting challenges and lessons learned. Front Surg. 2023;10:1260355.
Falih Noori I. Rectovaginal fistulas, outcomes of various surgical repair and predictive factors of healing success. A retrospective cohort study of 40 cases. International Journal of Surgery Open. 1 mai 2021;32:100335.
Das B, Snyder M. Rectovaginal Fistulae. Clinics in Colon and Rectal Surgery. mars 2016;29(1):50.
Beksac K, Tanacan A, Ozgul N, Beksac MS. Treatment of Rectovaginal Fistula Using Sphincteroplasty and Fistulectomy. Obstetrics and Gynecology International. 6 mai 2018;2018:5298214.
Pollaczek L, Rajagopal K, Chu J. Patient characteristics, surgery outcomes, presumed aetiology and other characteristics of fistula surgeries and related procedures supported by Fistula Foundation from 2019 to 2021: a multicentre, retrospective observational study. BMJ Open. 13 mars 2024;14(3):e078426.
Obstetric fistula repair failure and its associated factors among women underwent repair in Yirgalem Hamlin fistula center, Sidama Regional State, Southern Ethiopia, 2021: a retrospective cross sectional study | BMC Women’s Health | Full Text [Internet]. [cité 17 oct 2024]. Disponible sur: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-022-01866-z
Dawes AJ, Jensen CC. Rectovaginal Fistulas Secondary to Obstetrical Injury. Clin Colon Rectal Surg. janv 2021;34(1):28‑39.
Kniery KR, Johnson EK, Steele SR. Operative considerations for rectovaginal fistulas. World Journal of Gastrointestinal Surgery. 27 août 2015;7(8):133.
Bhome R, Monga A, Nugent KP. A transvaginal approach to rectovaginal fistulae for the colorectal surgeon: technical notes and case series. Techniques in Coloproctology. 30 mars 2018;22(4):305.