1/28. Pyloric atresia associated with epidermolysis bullosa, malrotation, and high anorectal malformation with recto-urethral fistula: a report of successful management.Pyloric atresia (PA) is an uncommon anomaly that may be associated with many other congenital anomalies, the commonest of which is junctional epidermolysis bullosa (JEB). Most of the cases of PA associated with JEB (Herlitz syndrome) reported have been fatal. A case of PA associated with JEB, malrotation, and a high anorectal malformation with a rectourethral fistula, which was hitherto undescribed, was successfully managed at our institution.- - - - - - - - - - ranking = 1keywords = atresia (Clic here for more details about this article) |
2/28. Repair of traumatic urethral fistula and huge tissue defect with Lehoczky's island flap.A 20-years-old male patient suffered pelvic bone fracture and a penetrating urethral injury through the perineum due to a car accident. The injury and the unsuccessful reconstruction resulted in a large perineal tissue defect, urethral fistula, and dislocation of the anus close to the fistula. The authors performed a successful reconstruction; closure of the urethral fistula, sinking of the anus to its proper place, and substitution of the missing skin and subcutaneous tissue with Lehoczky's flap. The flap with its good blood supply and mass of tissue repaired the defect and promoted the rapid, functionally and cosmetically excellent result.- - - - - - - - - - ranking = 1.9268372215422keywords = anus (Clic here for more details about this article) |
3/28. Calcified intraluminal meconium in newborn males with imperforate anus. Enterolithiasis in the newborn.Five cases are reported and reference is made to 3 previous similar cases of calcified intraluminal meconium in newborn males with "imperforate anus." A rectourinary fistula was found in most of the patients; none of the cases had meconium peritonitis. The calcifications may develop in areas of prolonged stasis; the possible added role of the mixture of urine and meconium in utero is raised.- - - - - - - - - - ranking = 4.8170930538555keywords = anus (Clic here for more details about this article) |
4/28. Urethrorectal fistula by bull horn injury.Bull horn injuries are common in rural india. Here one such case causing urethrorectal fistula has been reported. The patient was presented with history of bull horn injury 6 hours back. He was examined under general anaesthesia and found to have lacerations in the anus and anterior wall of rectum. Urgent retrograde urethrography and cystography showed partial rupture of bulbar urethra and urethrorectal fistula. Initially sigmoid colostomy and suprapubic cystostomy was done. Later optical internal urethrotomy was done. The patient was catheterised for 3 weeks and the fistula healed completely.- - - - - - - - - - ranking = 0.9634186107711keywords = anus (Clic here for more details about this article) |
5/28. Congenital urethral fistula with normal anus: a report of two cases.Congenital rectourethral or anourethral fistulae without imperforate anus in males are rare, representing less than 1% of anorectal malformations. We report our experience with two males with "N type" urethral fistulae. One, a 5-year-old boy, presented with recurrent urinary tract infections (UTIs) and passage of urine per anus. Investigations included a voiding cystourethrogram (VCUG), which demonstrated a fistula from the urethra to the anus. On physical examination, a small perianal opening was noted just outside the anus, which drained a small amount of urine after voiding. The fistula was excised via a perineal approach. The second patient is a 5-year-old boy with a long history of recurrent UTI requiring multiple hospitalizations since the newborn period. Chronic renal failure developed as a complication of repeated urinary tract infections. Investigations showed a single hydronephrotic pelvic kidney and a small bladder. He underwent numerous diagnostic and reconstructive procedures including cystoscopy and augmentation cystoplasty. Recurrent infections continued and an N type anourethral fistula was eventually diagnosed. The fistula was located between the anal canal and the membranous urethra. An anterior perineal approach was also used. Both fistulae were easily located, and reconstructive surgery of the urethra was not required. Postoperative VCUGs in both patients were normal. They have been free of infection with normal urinary continence since resection of the fistula. Congenital N type anourethral fistulae are rare, but should be considered in cases of recurrent urinary tract infections. The diagnosis may be missed by endoscopic procedures, but VCUG should demonstrate the fistulous tract.- - - - - - - - - - ranking = 7.7073488861688keywords = anus (Clic here for more details about this article) |
6/28. Endorectal pull-through with posterior sagittal approach to the repair of postoperative rectourethral and rectovaginal fistula.BACKGROUND/PURPOSE: Rectourethral (RUF) or rectovaginal fistula (RVF) is a troublesome complication after anorectal surgery because of dense adhesions around the fistula. The authors applied a new technique for the redo surgery. methods: Case 1 is Hirschsprung's disease in a 1-year-old boy who underwent modified Duhamel's procedure and had RUF. Case 2 is rectovestibular fistula in an 11-year-old girl who had anterior sagittal anorectoplasty complicated by RVF. Case 3 is multiple urogenital anomalies including rectovesical fistula in a 4-year-old boy in whom transvesical repair was unsuccessful. The colon was mobilized as far as possible at laparotomy. The rectum was opened via a posterior sagittal approach leaving 1 cm of the anal canal. Extended endorectal mucosectomy was performed to the dentate line, and the fistula was closed from inside of the rectum. The remaining mucosal cuff was everted out of the anus and the intact colon was pulled through the rectum and anastomosed to the cuff extraanally. RESULTS: The postoperative contrast enema showed no recurrent fistula, and defecation was not impaired. CONCLUSIONS: Endorectal pull-through of the intact colon can spare troublesome mobilization of the fistula and can prevent the recurrence of fistula. Rectal incision via a posterior sagittal approach provides a direct view of the fistula.- - - - - - - - - - ranking = 0.9634186107711keywords = anus (Clic here for more details about this article) |
7/28. Anorectal agenesis with a rectourethral fistula diagnosed in an adult: report of a case.We report an unusual case of anorectal agenesis with a rectourethral fistula diagnosed in a 48-year-old man. The patient presented after noticing hematuria, although he had been aware of urinary leakage from his colostomy with occasional fecal urine for about 4 years. He had had a double-barrel colostomy created soon after birth for an imperforate anus, with revision at the age of 4 years to correct a prolapse of the stoma, but his malformation had never been repaired. We performed a physical examination, which did not reveal a perineal fistula, but urethrocystography demonstrated high anorectal agenesis with a rectourethral fistula. Thus, we resected the rectourethral fistula and created an end-colostomy. The patient had an uneventful postoperative course, and was discharged in good health on postoperative day 19. To our knowledge, this is the oldest patient to be diagnosed with anorectal agenesis and undergo resection of a rectourethral fistula.- - - - - - - - - - ranking = 0.9634186107711keywords = anus (Clic here for more details about this article) |
8/28. Posterior urethral diverticulum after laparoscopic-assisted repair of high-type anorectal malformation in a male patient: surgical treatment and prevention.Currently, laparoscopic-assisted colon pull-through (LACPT) is the treatment of choice for male patients with high-type imperforate anus and rectourethral fistula. Since laparoscopy was introduced for treating this condition, reports concerning post-LACPT complications are rare. Here we discuss the case of a boy, now 3.5 years old, born at 37 weeks' gestation weighing 2,300 g, who was diagnosed with rectobulbar urethral fistula (RUF) at birth. LACPT was performed when the boy was 11 months old and weighed 7.2 kg. No intraoperative complications occurred, and the initial post-LACPT course was uneventful. When he was 2 years old, he developed dysuria requiring urethral catheterization. Diagnostic radiology confirmed a large cystic mass behind the bladder, suggestive of a posterior urethral diverticulum (PUD). Histopathology of the excised mucosa of the cyst showed colonic mucosa, confirming that the cyst was indeed an enlarged residual RUF. We discuss our treatment and our approach to prevention.- - - - - - - - - - ranking = 0.9634186107711keywords = anus (Clic here for more details about this article) |
9/28. The prenatal diagnosis of imperforate anus with rectourinary fistula: dilated fetal colon with enterolithiasis.The finding of extraluminal calcifications is commonly reported and usually indicates intrauterine intestinal perforation with intraperitoneal extravasation of meconium, most often associated with intestinal obstruction and/or atresias. Intraluminal calcification of meconium is more rare and appears to result from the mixing of stagnant urine and meconium in utero. The presence of the intraluminal calcifications in a dilated loop of intestine, particularly with an associated urinary tract abnormality, should suggest a rectourinary fistula. Two cases of prenatally diagnosed imperforate anus with rectourinary fistulae are reported.- - - - - - - - - - ranking = 5.0170930538555keywords = anus, atresia (Clic here for more details about this article) |
10/28. A case of rectal atresia associated with recto-bulbar urethral fistula.Rectal atresia is a rare condition in which the anus and sphincter muscles are normally developed, with usually no fistulous communication with the urinary tract. An unusual case of rectal atresia associated with recto-bulbar urethral fistula treated by a combination of colo-anal anastomosis and mucosal proctectomy via a posterior sagittal approach is reported for the first time.- - - - - - - - - - ranking = 2.1634186107711keywords = anus, atresia (Clic here for more details about this article) |
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