Koizumi Michihiro, Morimoto Koji, Kubota Itaru, Kubota Yawara, Tamura Shuzo, Otsuka Shinichi, Yamada Takeshi, Yoshida Hiroshi
Kitasenju Coloproctology Clinic, Tokyo, Japan.
Nishiarai Coloproctology Clinic, Tokyo, Japan.
J Anus Rectum Colon. 2025 Apr 25;9(2):276-280. doi: 10.23922/jarc.2024-022. eCollection 2025.
We report a rare case of an ano-Bartholin's gland fistula caused by an anal fistula in a patient without Crohn's disease (CD). A 34-year-old woman was admitted to our hospital due to purulent anal discharge and left vulvar pain. She had experienced several Bartholinitis in the past 2 years. She had no history of inflammatory bowel disease or other relevant conditions. A transanal ultrasound scan and pelvic magnetic resonance imaging showed a transsphincteric anal fistula connecting to an ano-Bartholin's gland abscess in the left vulva. Surgical findings showed that the primary opening of the anal fistula was located between the dentate line and anal verge. The fistula was treated with a sphincter-preserving subcutaneous incision of the fistula tract and internal sphincterotomy, and the Bartholin's gland abscess was effectively managed with drainage alone without excision. The postoperative recovery was successful, with no disturbance in defecation or sexual function. Although complex anal fistulas involving the female genital organs sometimes occur in patients with CD, they are exceedingly rare in patients without CD. This case shows that such fistulas can be managed with targeted anal fistula procedures with minimal invasion of the perineal area.
我们报告一例非克罗恩病（CD）患者因肛瘘导致的罕见肛管 - 巴氏腺瘘病例。一名34岁女性因脓性肛门分泌物和左侧外阴疼痛入院。在过去2年中，她曾经历过几次巴氏腺炎。她无炎症性肠病或其他相关疾病史。经肛门超声扫描和盆腔磁共振成像显示，一个经括约肌肛瘘与左侧外阴的肛管 - 巴氏腺脓肿相连。手术发现肛瘘的原发开口位于齿状线和肛缘之间。采用保留括约肌的瘘管皮下切开术和内括约肌切开术治疗肛瘘，巴氏腺脓肿仅通过引流有效处理，未行切除。术后恢复顺利，排便及性功能均无异常。虽然累及女性生殖器官的复杂性肛瘘有时见于CD患者，但在非CD患者中极为罕见。本病例表明，此类瘘管可通过针对性的肛瘘手术进行处理，对会阴区域的侵袭最小。
