WordNet
- an abnormal passage leading from a suppurating cavity to the body surface (同)sinus
PrepTutorEJDIC
- 瘻(ろう)菅(長い菅状になった潰瘍)
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/08 15:23:23」(JST)
[Wiki en表示]
| Rectovaginal fistula |
| Classification and external resources |
Rectovaginal fistula
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| ICD-10 |
N82.3, Q52.2 |
| ICD-9 |
619.1 |
| DiseasesDB |
32573 |
| eMedicine |
med/2745 |
| MeSH |
D012006 |
A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina.[1]
Rectovaginal fistula may be extremely debilitating. If the opening between the rectum and vagina is wide it will allow both flatulence and feces to escape through the vagina, leading to fecal incontinence. There is an association with recurrent urinary and vaginal infections. This type of fistula can cause pediatricians to misdiagnose imperforate anus. The severity of the symptoms will depend on the size of fistula. Most often, it appears after about one week or so following delivery.
Contents
- 1 Causes
- 2 Treatment
- 3 References
- 4 External links
Causes[edit]
Rectovaginal fistulae are often the result of trauma during childbirth (in which case it is known as obstetric fistula) in situations where there is inadequate health care, such as in some developing countries. Risk factors include prolonged labour, difficult instrumental delivery and paramedian episiotomy. Rates in Eritrea are estimated as high as 350 per 100,000 vaginal births. Fistulas can also develop in women and children who are raped; women with rectovaginal fistulae are often stigmatized in third world countries, and become outcasts.[2]
Rectovaginal fistulae can also be a symptom of various diseases, including infection by lymphogranuloma venereum,[3] or the unintended result of surgery, such as episiotomy or sexual reassignment surgery. They may present as a complication of vaginal surgery, including vaginal hysterectomy. They are a recognized presentation of rectal carcinoma or rarely diverticular disease of the bowel or Crohn's disease. They are seen rarely after radiotherapy treatment for cervical cancer.
Treatment[edit]
After diagnosing rectovaginal fistula, it is best to wait for around 3 months to allow the inflammation to subside. If the fistula is small, it will heal spontaneously during this time interval. For low fistulae, a vaginal approach is best, while an abdominal repair would be necessary for a high fistula at the posterior fornix.
A circular incision is made around the fistula and vagina is separated from the underlying rectum with a sharp circumferential dissection. The entire fistulous tract, along with a small rim of rectal mucosa is incised. The rectal wall is then closed extramucosally.[4]
References[edit]
- ^ Kumaran SS, Palanivelu C, Kavalakat AJ, Parthasarathi R, Neelayathatchi M (2005). "Laparoscopic repair of high rectovaginal fistula: Is it technically feasible?". BMC Surg 5: 20. doi:10.1186/1471-2482-5-20. PMC 1266383. PMID 16221302.
- ^ http://www.msmagazine.com/spring2005/congo.asp
- ^ Lynch CM, Felder TL, Schwandt RA, Shashy RG (1999). "Lymphogranuloma venereum presenting as a rectovaginal fistula". Infect Dis Obstet Gynecol 7 (4): 199–201. doi:10.1155/S1064744999000344. PMC 1784745. PMID 10449269.
- ^ "Rectovaginal fistula: Treatment and Management". Medscape. Retrieved 14 August 2012.
External links[edit]
- Rectovaginal fistula at the Open Directory Project
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Female diseases of the pelvis and genitals (N70–N99, 614–629)
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| Internal |
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Adnexa
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Ovary
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Oophoritis · Ovarian cyst (Follicular cyst of ovary, Corpus luteum cyst, Theca lutein cyst) · Endometriosis of ovary · Ovarian hyperstimulation syndrome · Ovarian torsion · Ovarian apoplexy · Mittelschmerz · Female infertility (Anovulation, Poor ovarian reserve)
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Fallopian tube
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Salpingitis · Hydrosalpinx · Hematosalpinx · Female infertility (Fallopian tube obstruction)
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Uterus
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Endometrium
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Endometritis · Endometriosis · Endometrial polyp · Endometrial hyperplasia · Asherman's syndrome · Dysfunctional uterine bleeding
menstruation: flow (Amenorrhoea, Hypomenorrhea, Oligomenorrhea) · timing (Menorrhagia, Menometrorrhagia, Metrorrhagia) · pain (Dysmenorrhea, PMS)
Female infertility (Habitual abortion)
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Myometrium
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Adenomyosis
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Parametrium
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Parametritis
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Cervix
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Cervicitis · Cervical polyp · Nabothian cyst · Cervical incompetence · Female infertility (Cervical stenosis) · Cervical dysplasia
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General
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Hematometra/Pyometra · Retroverted uterus
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Vagina
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Vaginitis (Bacterial vaginosis, Atrophic vaginitis, Candidal vulvovaginitis) · Leukorrhea/Vaginal discharge · Hematocolpos/Hydrocolpos
Sexual dysfunction (Dyspareunia, Hypoactive sexual desire disorder, Sexual arousal disorder, Vaginismus)
Prolapse (Cystocele, Rectocele, Enterocele, Sigmoidocele, Urethrocele) · Fistulae (Vesicovaginal, Rectovaginal)
Vaginal bleeding
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Other/general
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Pelvic inflammatory disease · Pelvic congestion syndrome
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| External |
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Vulva
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Vulvitis · Bartholin's cyst · Kraurosis vulvae · Vulvodynia · Vestibular papillomatosis
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Clitoral hood or Clitoris
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Clitoral phimosis · Clitorism
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noco/cong/npls, sysi/epon
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proc/asst, drug (G1/G2B/G3CD)
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Female congenital anomalies of the genitalia, including Intersex and DSD: (Q50–Q52; 752.0–752.4)
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| Internal |
| Uterine malformation |
- Müllerian agenesis
- Unicornuate uterus
- Uterus didelphys
- Bicornuate uterus
- Uterine septum
- Arcuate uterus
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| Vagina |
- Vaginal septum
- Vaginal atresia
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| External |
- Clitoromegaly
- Progestin-induced virilisation
- Pseudohermaphroditism
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noco/cong/npls, sysi/epon
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proc/asst, drug (G1/G2B/G3CD)
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UpToDate Contents
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English Journal
- Phase II Study of Bevacizumab and Chemoradiation in the Preoperative or Adjuvant Treatment of Patients With Stage II/III Rectal Cancer.
- Spigel DR, Bendell JC, McCleod M, Shipley DL, Arrowsmith E, Barnes EK, Infante JR, Burris HA 3rd, Greco FA, Hainsworth JD.SourceSarah Cannon Research Institute, Nashville, TN; Tennessee Oncology, PLLC, Nashville, TN.
- Clinical colorectal cancer.Clin Colorectal Cancer.2011 Aug 12. [Epub ahead of print]
- BACKGROUND AND PURPOSE: We wanted to evaluate the efficacy, defined as 2-year disease-free survival (DFS), and safety of bevacizumab/chemoradiation in preoperative and adjuvant settings for patients with stage II/III rectal cancer.PATIENTS AND METHODS: Eligible patients had stage II/III rectal adeno
- PMID 21840771
Japanese Journal
Related Links
- A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. Rectovaginal fistula may be extremely debilitating. If the opening between the rectum and vagina is wide it ...
Related Pictures
★リンクテーブル★
[★]
- 英
- rectovaginal fistula
- 関
- 直腸膣瘻
[★]
- 英
- rectovaginal fistula
- 関
- 直腸腟瘻