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Rectovaginal Fistula in a 10-Year-Old With Hirschsprung Disease: A Case Report
Jomaries O Gomez Rosado1, Courteney Castellano1, Jossias Genao Cruz2
1College of Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA.
Insights
Hirschsprung disease, a condition affecting bowel motility, can lead to rare complications. This case highlights a complex pediatric presentation involving rectovaginal fistula and severe anemia.
Area of Science:
- Pediatric Gastroenterology
- Surgical Case Reports
Background:
- Hirschsprung disease results from absent ganglion cells in the colon, causing functional obstruction.
- It is a congenital condition leading to chronic constipation and intestinal issues.
Observation:
- A 10-year-old female with prior colectomy for Hirschsprung disease presented with colonic ulcers and anemia.
- The patient developed a rectovaginal fistula, paralytic ileus, perianal/vaginal excoriations, and fecal incontinence.
Findings:
- This case details a rare and severe complication of Hirschsprung disease in a pediatric patient.
- The complexity involved multiple gastrointestinal and pelvic floor dysfunctions.
Implications:
- Highlights the potential for severe, uncommon complications in patients with Hirschsprung disease.
- Emphasizes the need for vigilant monitoring and comprehensive management in complex pediatric cases.
Abstract:
Hirschsprung disease is an uncommon medical condition caused by the lack of migration of ganglion cells to the rectum during embryonic development, affecting the peristaltic movements of the intestine. It is a chronic medical condition responsible for chronic constipation and intestinal obstruction. We present the case of a 10-year-old female with a history of Hirschsprung disease and colectomy admitted to a pediatric hospital for the management of multiple colonic ulcers and severe anemia who subsequently developed a rectovaginal fistula. This patient's admission was complicated by perianal and vaginal excoriations, a paralytic ileus, and fecal incontinence. This case report is unique due to the development of a rare pediatric complication of Hirschsprung disease.
