Sarin Yogesh Kumar, Sinha Arvind
Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
J Pediatr Surg. 2002 Aug;37(8):1217-9. doi: 10.1053/jpsu.2002.34480.
The authors describe 4 cases of rectovestibular fistula associated with uterovaginal atresia. The diagnosis of the associated uterovaginal atresia was missed in the neonatal period in all 4. It was diagnosed in 2 cases at puberty while investigating for amenorrhea; the other 2 were discovered during the repair of anorectal malformation in early childhood. A variety of techniques were used successfully for vaginal reconstruction. The authors believe that the incidence of such an association is very similar to that of imperforate anus with rectovaginal fistula and therefore suggest that if there are 2 orifices in the perineum of a girl with imperforate anus, it could be either a rectovaginal fistula or a rectovestibular fistula with uterovaginal agenesis. They recommend that all such neonates have an endoscopy or a magnetic resonance imaging done to distinguish between the 2 conditions. This distinction is of importance because the latter would require a concomitant vaginal reconstruction procedure along with anorectoplasty.
作者描述了4例与子宫阴道闭锁相关的直肠前庭瘘病例。在所有4例中，新生儿期均漏诊了相关的子宫阴道闭锁。2例在青春期因闭经进行检查时被诊断；另外2例是在幼儿期肛门直肠畸形修复过程中发现的。多种技术成功用于阴道重建。作者认为，这种关联的发生率与肛门闭锁合并直肠阴道瘘的发生率非常相似，因此建议，如果肛门闭锁的女孩会阴部有两个开口，可能是直肠阴道瘘或伴有子宫阴道发育不全的直肠前庭瘘。他们建议所有此类新生儿进行内镜检查或磁共振成像，以区分这两种情况。这种区分很重要，因为后者需要在肛门直肠成形术的同时进行阴道重建手术。
