Abstract
Background
Rectovaginal fistulas are often associated with obstetric trauma and present with
leakage of stool or flatus from the vagina. They are often repaired via fistulaectomy
but sometimes more complex repairs are needed. There is limited data regarding success
using fibrin glue to close the tract.
Case
A developmentally delayed pediatric patient presented with right hip pain. Imaging
studies identified a hairpin penetrating the rectovaginal space. The hairpin was removed
during an exam under anesthesia, and the subsequent rectovaginal fistula was closed
with fibrin glue. Closure of the tract has persisted for greater than one year without
need for further intervention.
Summary and Conclusion
Fibrin glue may be a minimally invasive and safe approach for rectovaginal fistulas
in the pediatric patient.
Keywords
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References
- The disappointing quality of published studies on operative techniques for rectovaginal fistulas: a blueprint for a prospective multi-institutional study.Dis Colon Rectum. 2014 Jul; 57 (PMID: 24901691): 888-898https://doi.org/10.1097/DCR.0000000000000147
- Long-term results in the treatment of fistula-in-ano with fibrin glue: a prospective study.J Korean Surg Soc. 2011 Sep; 81 (Epub 2011 Sep 26. PMID: 22066118; PMCID: PMC3204547): 169-175https://doi.org/10.4174/jkss.2011.81.3.169
- Rectovaginal fistula in Crohn's disease.Dis Colon Rectum. 2007 Dec; 50 (Epub 2007 Sep 11. PMID: 17846837): 2215-2222https://doi.org/10.1007/s10350-007-9057-7
- Surgical repair of rectovaginal fistulas: predictors of fistula closure.Int Urogynecol J. 2019 Oct; 30 (Epub 2019 Aug 29. PMID: 31468097; PMCID: PMC6795627): 1659-1665https://doi.org/10.1007/s00192-019-04082-w
- What is the best method of rectovaginal fistula repair? A 25-year single-center experience.Tech Coloproctol. 2021 Sep; 25 (Epub 2021 Jun 8. PMID: 34101044): 1037-1044https://doi.org/10.1007/s10151-021-02475-y
- The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula.Dis Colon Rectum. 2022 Aug 1; 65 (Epub 2022 Jul 5. PMID: 35732009): 964-985https://doi.org/10.1097/DCR.0000000000002473
- Management of sexual assault-related large rectovaginal fistula in an eight-year-old.J Pediatr Adolesc Gynecol. 2011 Apr; 24 (Epub 2010 Dec 28. PMID: 21190877): e39-e41https://doi.org/10.1016/j.jpag.2010.11.009
- A rectovaginal fistula in a sexually assaulted child.Clin Pediatr (Phila). 1996 Jul; 35 (PMID: 8829008): 369-371https://doi.org/10.1177/000992289603500707
Huang X, Tan SS, Chen Y, Li T. Acquired Rectourethral and Rectovaginal Fistulas in Children: A Systematic Review. Front Pediatr. 2021 May 7;9:657251. doi: 10.3389/fped.2021.657251. PMID: 34026691; PMCID: PMC8138555.
- Pediatric injuries: prevention to resolution.Surg Clin North Am. 2007 Feb; 87 (viiiPMID: 17127129): 207-228https://doi.org/10.1016/j.suc.2006.09.016
Article info
Publication history
Accepted:
February 25,
2023
Received in revised form:
February 17,
2023
Received:
November 16,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of North American Society for Pediatric and Adolescent Gynecology.