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[罕见的伴有直肠-尿道球部瘘的肛门直肠畸形:病例报告]

[Rare anorectal malformation with recto-uretrobulbar fistula: about a case].

作者信息

Alaoui Othmane, Abdellaoui Hicham

机构信息

Service de chirurgie pédiatrique viscérale, CHU Hassan II, Université Sidi Mohamed Ben Abdallah, Fès, Maroc.

出版信息

Pan Afr Med J. 2017 Nov 22;28:255. doi: 10.11604/pamj.2017.28.255.14299. eCollection 2017.

Abstract

We here report the case of a male newborn admitted immediately after birth with imperforate anus. Physical examination of the anal margin showed imperforate anus; the examination of the external genitalia objectified scrotal bifidity with a fistula filled with meconium at the level of the penis root. During urinary catheterization the catheter passed through the fistula (A), suggesting a rare anorectal malformation with recto-uretrobulbar fistula. Malformation assessment was without abnormalities. The newborn was admitted to the operating room and clouding was performed during surgery by catheterization of the fistula using two 6 CH (1.98mm) Foley catheters, one passing through the rectum and the other passing through the bladder; a third foley catheter passed through the urethral meatus, objectifying the communication among the three catheters at the level of the recto-uretrobulbar fistula (B). The diagnosis of rare intermediate anorectal malformation was retained and colostomy was performed. The newborn underwent treatment based on perineal anorectoplasty with fistula closure at the age of 3 months. Anal dilatation was performed for 6 months. Colostomy closure was performed at the age of 9 months. Patient's evolution was favorable at 2-year follow-up.

摘要

我们在此报告一例男性新生儿,出生后立即因肛门闭锁入院。肛门边缘体格检查显示肛门闭锁;外生殖器检查发现阴囊分裂,在阴茎根部水平有一个充满胎粪的瘘管。导尿时导管通过瘘管(A),提示一种罕见的直肠尿道球部瘘的肛门直肠畸形。畸形评估未发现异常。新生儿被送入手术室,手术中通过使用两根6 CH(1.98mm)Foley导管经瘘管插管进行造影,一根通过直肠,另一根通过膀胱;第三根Foley导管经尿道口插入,显示在直肠尿道球部瘘水平三根导管之间的连通情况(B)。确诊为罕见的中间型肛门直肠畸形并进行了结肠造口术。该新生儿在3个月大时接受了基于会阴肛门直肠成形术并闭合瘘管的治疗。进行了6个月的肛门扩张。9个月大时进行了结肠造口关闭术。在2年的随访中患者情况良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/942a/5989255/a7506ae567f4/PAMJ-28-255-g001.jpg

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