Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
Yonsei Med J. 2010 Sep;51(5):717-21. doi: 10.3349/ymj.2010.51.5.717.
We investigated whether infantile vulvar abscesses are predictable features of rectovestibular fistula with a normal anus.
A retrospective analysis of five infants with vulvar abscesses and rectovestibular fistulae with normal anuses was performed.
Four cases had a left vulvar abscess, and in one case the vulvar abscess was on the right side. All caregivers reported passage of stool from the vagina. The fistulae were almost uniformly located from the vestibule to the rectum above the anal dentate line, observable by visual inspection and probing under anesthesia. The first two cases were treated with division and closure of the fistulae after a diverting loop colostomy, and the remaining three cases with fistulotomy and curettage. There was no recurrence during the median follow-up period of 38 months.
This unique rectovestibular fistula should be suspected in female infants with vulvar abscesses, especially when parents report passage of stool from the vagina. Fistulotomy and curettage may be an initial treatment and effective as a temporary diverting colostomy and delayed repair of the fistula.
我们研究了婴儿外阴脓肿是否是肛门正常的直肠前庭瘘的可预测特征。
对 5 例有外阴脓肿和直肠前庭瘘但肛门正常的婴儿进行了回顾性分析。
4 例左侧外阴脓肿，1 例右侧外阴脓肿。所有的照顾者都报告说有粪便从阴道排出。瘘管几乎均匀地位于前庭至齿状线以上的直肠，可通过麻醉下的目视检查和探查观察到。前两例在横结肠造口术分流后行瘘管切开和闭合治疗，其余 3 例行瘘管切开和刮除术。在平均 38 个月的随访期间，无复发。
对于有外阴脓肿的女性婴儿，尤其是当父母报告粪便从阴道排出时，应怀疑存在这种独特的直肠前庭瘘。瘘管切开和刮除术可能是一种初始治疗方法，与横结肠造口术分流和延迟修复瘘管一样有效。
