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Spontaneous scrotal faecal fistula in an infant
L S Kasat1, V S Waingankar, T Kamat
1Department of Paediatric Surgery, B.J. Wadia Hospital for Children, Parel, Mumbai, India.
Insights
A rare case of a neonatal scrotal fecal fistula, caused by a burst inguinal hernia, was successfully treated with ileal resection and anastomosis. This life-threatening condition required prompt surgical intervention for bowel decompression.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Neonatal Care
Background:
- Incarcerated inguinal hernias in neonates can lead to rare but severe complications.
- A scrotal fecal fistula is an extremely uncommon presentation of a neonatal inguinal hernia.
Observation:
- A 2-month-old male infant presented with a left scrotal fecal fistula.
- This resulted from the spontaneous rupture of an incarcerated inguinal hernia after 8 days.
- The hernia caused complete decompression of the small bowel through the fistula.
Findings:
- Surgical intervention involved incising the inguinal ring and performing resection and end-to-end anastomosis of the involved ileal loop.
- The procedure was successfully completed via an inguinal approach.
- This case represents one of only three reported instances in the global medical literature.
Implications:
- Highlights the critical need for timely diagnosis and surgical management of neonatal inguinal hernias.
- Emphasizes the potential for catastrophic complications, including fecal fistula formation.
- Contributes to the limited understanding and documentation of this rare surgical emergency in infants.
Abstract:
A 2-month-old, full-term male presented with a left scrotal faecal fistula due to spontaneous bursting of an incarcerated inguinal hernia for 8 days, with complete decompression of the small bowel through it. Resection and end-to-end anastomosis of the engaged ileal loop was successfully done after incising the ring via the inguinal approach. Only two such cases have been reported in the world literature to date.