Colorectal duplication with rectovestibular fistula treated through an anterior transanorectal approach

Abstract

Introduction: Colorectal duplications (CRD) end as a blind sac, communicate to the native colon/rectum or as an external fistula. The treatment depends on duplication type and length. Case presentation: We present a case of a 2-year-old female patient, with a history of stool output through the vagina at 12 months of life. On physical examination anus was well located and patent. Contrast study showed a CRD ending in a rectovestibular fistula (RVF) and the native colon in the anus. The RVF was resected and the duplicated anterior rectum was connected to the native rectum through an anterior transanorectal approach (ATA) without complications. The patient is currently passing stool through the anus and fecally continent. Discussion: CRD have a great variety of presentations. The contrast study is fundamental to obtain an accurate diagnosis. They are considered benign lesions, so colonic resection is not mandatory. Different surgical approaches have been published. In the present case, we report a CRD with a RVF which was successfully corrected using a primary ATA approach. Conclusion: CRD ending in a RVF are rare lesions that require deep diagnostic approach and can be treated by resecting the fistula, connecting the duplicated rectum to the native one through an ATA approach.

Keywords

• Colonic duplication
• Alimentary tract duplications
• Rectovestibular fistula