:Ano-vestibular Fistula or Recto-vestibular Fistula?

概要

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We experienced two cases of female anorectal malformations with vestibular fistula, in whom the differential diagnosis between intermediate type and low type was very difficult. In both of them the final diagnosis, that was low type of the ano-vestibular fistula, was confirmed only by means of manometric study. It revealed a functional internal sphincter showing an anal canal rhythmic wave and a positive recto-anal reflex. In one case, the cut back operation was performed with a good result in her anal function, in the other case, the anal transplantation with a poor result.<BR>In conclusion, the manometric study seems to be an useful preoperative diagnostic method for the female anorectal malformations with vestibular fistula : ano-vestibular fistula (low type) in the presence of anal canal rhythmic waves and recto-anal reflexes, recto-vestibular fistula (intermediate type) in the absence of them. From the functional point of view, the cut back operation is the first choice for ano-vestibular fistula, rather than the anal transplantation.
日本大腸肛門病学会の論文