Shimamura Yuto, Fujikawa Aoi, Kubota Keisuke, Ishii Naoki, Fujita Yoshiyuki, Ohta Keiichiro
Division of Gastroenterology, St, Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.
J Med Case Rep. 2015 Jan 23;9:24. doi: 10.1186/1752-1947-9-24.
There are several techniques for creation of a neovagina in male-to-female reassignment surgery. Although vaginoplasty with the sigmoid colon is not a common procedure, it is becoming more common. Perforation of the recto-sigmoid neovagina after sex reassignment surgery is very rare. We hereby report a case of perforation of the neovagina that presented as acute peritonitis, with a massive abscess in the intra-abdominal cavity.
This case report describes a 33-year-old Asian woman presenting with mild persistent abdominal pain, nausea, and vomiting who had undergone male-to-female sex reassignment surgery four years prior. Physical examination revealed mild abdominal pain without rebound tenderness. An abdominal computed tomography scan showed a massive abscess that occupied a significant portion of the intra-abdominal cavity. Perforation of the neovagina was confirmed by exploratory laparotomy and surgical drainage with primary closure was performed without any complications.
This is a rare case involving perforation of the neovagina that was successfully treated with surgical intervention. This case emphasizes the importance of taking a detailed medical history and to make physicians and patients aware that bowel vaginoplasty can result in a weak vagina.
在男性向女性性别重置手术中，有多种创建新阴道的技术。虽然乙状结肠阴道成形术并非常见手术，但正变得越来越普遍。性别重置手术后直肠乙状结肠新阴道穿孔极为罕见。我们在此报告一例新阴道穿孔病例，该病例表现为急性腹膜炎，腹腔内有巨大脓肿。
本病例报告描述了一名33岁亚洲女性，她在四年前接受了男性向女性性别重置手术，出现轻度持续性腹痛、恶心和呕吐。体格检查发现轻度腹痛，无反跳痛。腹部计算机断层扫描显示一个巨大脓肿占据了腹腔的很大一部分。经剖腹探查证实新阴道穿孔，并进行了手术引流及一期缝合，未出现任何并发症。
这是一例罕见的新阴道穿孔病例，通过手术干预成功治疗。该病例强调了详细询问病史的重要性，并让医生和患者意识到肠道阴道成形术可能导致阴道薄弱。
