Stephens F D, Donnellan W L
J Pediatr Surg. 1977 Feb;12(1):95-102. doi: 10.1016/0022-3468(77)90302-5.
Stephens and Smith have recently described a urethroanal connection through which urine was passed preferentially into the otherwise normal rectum at the pectinate line. Other authors have reported similar deformities. The term "congenital 'H-type' anourethral fistula" was proposed for this rare anomaly by deVries and Friedland in 1974. In this communication, we describe two examples of the "H-type" urethroanal fistula (Fig. 1). Each patient also had tracheoesophageal fistula. One patient (R.P.), now 11 yr of age, has had successful correction of the anomaly. The other patient (T.McC.), a small premature baby whose uroanal deformity was investigated radiographically, died of sepsis and uremia. The anatomical relationships in this baby were investigated histologically in the autopsy specimen by means of serial sections. From this study, it has been possible to determine the sphincteric anatomy and to suggest a possible pathoembryology of the defect.
斯蒂芬斯和史密斯最近描述了一种尿道肛门连接，尿液通过该连接优先排入齿状线处原本正常的直肠。其他作者也报道过类似的畸形情况。1974年，德弗里斯和弗里德兰德针对这种罕见的异常情况提出了“先天性‘H型’肛门尿道瘘”这一术语。在本报告中，我们描述了两例“H型”尿道肛门瘘（图1）。每位患者还患有气管食管瘘。一名患者（R.P.），现年11岁，已成功矫正该异常情况。另一名患者（T.McC.）是一名早产婴儿，其尿道肛门畸形通过影像学检查进行了评估，该患者死于败血症和尿毒症。通过对该婴儿尸检标本进行连续切片，从组织学角度研究了其解剖关系。通过这项研究，得以确定括约肌的解剖结构，并提出该缺陷可能的病理胚胎学机制。
