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Rectovaginal injury in a young child. A case report
Julie S Platt1, Catherine M Lynch
1Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa, USA. mdpjsp@earthlink.net
Background:
Rectovaginal injuries in children, often the result of trauma, present as emergencies. Associated injuries may include ruptured urethra, bladder, vaginal vault or hollow viscus.
Case:
A child younger than 2 years of age sustained a traumatic injury. Thorough examination required the use of skeletal radiography; computed tomography of the head, chest, abdomen and pelvis; and voiding cystourethrogram. Injury was limited to a fourth-degree perineal laceration. The wound was debrided and primarily closed in layered fashion. A diverting colostomy was performed to aid wound healing. Six weeks later, after wound resolution, colonic anastomosis was performed.
Conclusion:
Rectovaginal laceration in a child under the age of 13 requires thorough evaluation to identify the extent of traumatic injury. A diverting colostomy enhances wound healing.