Rectovestibular Fistula Without Imperforate Anus (Perineal Canal)

Abstract

Rectovestibular fistula without imperforate anus (perineal canal) is a relatively rare condition which is classified into miscellaneous deformities in the international classification of anorectal anomalies. In female neonates or early infants with this condition, a passage of feces or flatus from the vaginal vestibule or vulvitis is observed because of a fistulous tract which communicates between the anterior wall of the lower rectum and the vaginal vestibule with the normal anus. The fistula can be determined by inserting with a probe, and the fistulous tract is also confirmed by barium enema, fistulography, or stomatography. Treatment should be surgical and various surgical approaches have been described. The vestibulo-anal pull-through method which is one of perineal fistulectomy is recommended for this disease because of its simple, easy, and less invasive procedures. The role of colostomy in treating this condition is still controversial, but colostomy is greatly helpful in preventing wound infection or wound disruption.

The figures in this chapter are reprinted with permission from Standard Pediatric Operative Surgery (in Japanese), Medical View Co., Ltd., 2013, with the exception of occasional newly added figures that may appear.