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Rectovulvar fistula in a child secondary to an unusual foreign body
T E Nolan1, R M Hatley, C G Howell
1Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta.
Insights
A rare case of a 3-year-old child with recurrent vaginal discharge due to a large animal bone foreign body is presented. Surgical removal and colostomy successfully treated the rectovulvar fistula, the first non-congenital case reported.
Area of Science:
- Pediatric Surgery
- Gynecology
- Foreign Body Management
Background:
- Foreign bodies in the female genital tract commonly cause pain, discharge, and infection.
- In children, vaginal discharge often indicates inserted objects or sexual abuse with STDs.
- Recurrent labial secretions in a young child prompted investigation for an unusual cause.
Abstract:
Foreign bodies in the female genital tract are well recognized as a cause of pain, discharge, secretions, and infection. In the small child, the presence of a vaginal discharge is usually associated with either a common object which has been inserted or sexual abuse complicated by a sexually transmitted disease. A 3-year-old child presented with a recurrent labial secretion and drainage due to an unusual foreign body. It was only during a second operation that the possibility of a foreign body was entertained, and diagnostic testing was begun. A third operation permitted removal of the foreign body, a large bone probably of animal origin. The fistula tract was closed after a colostomy was performed. This represents the first reported case of a rectovulvar fistula not of a congenital nature.