Sivarajah Vernon, Bello Sean O Z, Yiu Chu Yiu, Oke Olatokunbo
Department of General Surgery, Queen Elizabeth Hospital, London, UK.
BMJ Case Rep. 2011 Oct 28;2011:bcr0920114823. doi: 10.1136/bcr.09.2011.4823.
A 67-year-old lady presented to the surgical outpatient clinic with a 4 month history of recurrent purulent discharge from her left buttock. Four years and 4 months prior to this she underwent a posterior intravaginal slingoplasty for vaginal prolapse and urinary stress incontinence. An MRI demonstrated a long gluteo-vaginal fistula tract from the posterior wall of the vaginal vault through the left ischiorectal fossa to the skin. An examination under anaesthesia revealed that the fistulous tract was surrounding the intact mesh used for the posterior intravaginal slingoplasty. The mesh was removed, the fistula tract excised and the perineal wound marsupialised. The patient was discharged 5 days later. The wound healed within 4 weeks and she remains sepsis free 2 years on.
一位67岁女性因左侧臀部反复脓性分泌物4个月就诊于外科门诊。在此之前的4年4个月，她因阴道脱垂和压力性尿失禁接受了后路阴道吊带成形术。磁共振成像（MRI）显示从阴道穹窿后壁经左侧坐骨直肠窝至皮肤的一条长的臀-阴道瘘管。麻醉下检查发现瘘管围绕着用于后路阴道吊带成形术的完整补片。取出补片，切除瘘管并将会阴伤口袋形缝合。患者5天后出院。伤口在4周内愈合，2年来一直未发生脓毒症。
