Repair of a recto-vaginal fistula as a result of sexual assault.

A thorough and careful examination should always be performed for a child with a presenting complaint of sexual abuse. Rarely will a child suffer extensive injuries requiring surgical repair. This case study is of a 4-year-old girl who sustained severe penetrating trauma of the vagina and rectum resulting in a recto-vaginal fistula. She presented 2 months after the assault and required anogenital reconstruction with a temporary colostomy. Initial and long-term surgical management of this case is discussed.