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Fibrin Glue Repair of a Traumatic Rectovaginal Fistula in a Pediatric Patient
Gregory Vurture1, Mark Kayton2, Victoriya Staab2
1Division of Pediatric Gynecology, Department of Obstetrics and Gynecology, Jersey Shore University Medical Center, Neptune, New Jersey.
Insights
Fibrin glue offers a safe and minimally invasive treatment for pediatric rectovaginal fistulas. This approach successfully closed a complex fistula in a pediatric patient, persisting for over a year.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Gynecology
Background:
- Rectovaginal fistulas commonly result from obstetric trauma, causing significant patient distress.
- Surgical repair is standard, but complex cases require advanced techniques.
- Limited data exist on fibrin glue efficacy for rectovaginal fistula closure.
Observation:
- A pediatric patient with developmental delays presented with right hip pain.
- Imaging revealed a hairpin penetrating the rectovaginal space.
- The hairpin was removed, and the resulting rectovaginal fistula was treated with fibrin glue.
Findings:
- Fibrin glue facilitated successful closure of the rectovaginal fistula.
- The closure remained effective for over one year post-intervention.
- No further procedures were required for fistula management.
Implications:
- Fibrin glue presents a potentially minimally invasive and safe option for pediatric rectovaginal fistulas.
- This case highlights a novel application of fibrin glue in pediatric surgical repair.
- Further research is warranted to establish fibrin glue as a standard treatment modality.
Background:
Rectovaginal fistulas are often associated with obstetric trauma and present with leakage of stool or flatus from the vagina. They are often repaired via fistulaectomy, but sometimes more complex repairs are needed. There are limited data regarding success using fibrin glue to close the tract.
Case:
A developmentally delayed pediatric patient presented with right hip pain. Imaging studies identified a hairpin penetrating the rectovaginal space. The hairpin was removed during an exam under anesthesia, and the subsequent rectovaginal fistula was closed with fibrin glue. Closure of the tract has persisted for more than 1 year without need for further intervention.
Summary And Conclusion:
Fibrin glue may be a minimally invasive and safe approach for rectovaginal fistulas in the pediatric patient.
