Prasil P, Nguyen L T, Laberge J M
Division of Pediatric General Surgery, The Montreal Children's Hospital, McGill University Health Centre, Quebec, Canada.
J Pediatr Surg. 2000 May;35(5):733-5. doi: 10.1053/jpsu.2000.6046.
Tubular duplication of the recto-sigmoid colon is a rare entity. Associated anomalies including fistulae to the genitourinary tract may be found. A baby girl was found to have duplication of the recto-sigmoid colon, anomalies of sacral vertebra from S1 to S5, and solitary right kidney. The septum of this duplication was divided using staplers. Because of a history of stool coming from the vagina, a meticulous examination perioperatively was performed, but no fistula could be found. Further extensive investigation failed to show any fistula. At the age of 10 she was operated on for a tethered cord. At age 14, she experienced passage of a small amount of liquid stool per vaginum. A recto-vaginal fistula was found. Via a posterior sagittal incision, the fistula was closed by a transrectal approach. She remained asymptomatic for 16 months until the fistula recurred. Using a perineal approach, a very short fistula between the vagina and the rectum was closed. The closure was reinforced by a vaginal flap. Four months later, she remains without signs of recurrence.
直肠乙状结肠管状重复畸形是一种罕见的病症。可能会发现包括与泌尿生殖道形成瘘管在内的相关异常情况。一名女婴被发现患有直肠乙状结肠重复畸形、骶椎 S1 至 S5 异常以及孤立性右肾。使用吻合器将该重复畸形的隔膜分开。由于有粪便从阴道排出的病史，术中进行了细致检查，但未发现瘘管。进一步广泛检查也未发现任何瘘管。10 岁时她因脊髓栓系接受手术。14 岁时，她出现经阴道排出少量液体粪便的情况。发现了直肠阴道瘘。通过后矢状切口，经直肠途径闭合了瘘管。她保持无症状 16 个月，直到瘘管复发。采用会阴途径，闭合了阴道与直肠之间一段非常短的瘘管。用阴道瓣加固了闭合处。四个月后，她仍无复发迹象。
