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Pediao4c
Surgery
International
© Springer-Verlag 1993
Introduction
ing muscle maintaining mucosal continuity between the tract and the
Case report anorectum. The external sphincter complex was restored by suturing the
cut ends with vicryl sutures and the perineal body was reconstructed. The
A 3-month-:dd female presented with passage of stools per vaginam as perineal canal mucosa, after being repositioned posteriorly in continuity
well as through the normal anal passage. There was no history of abscess with the anus, was now sutured to the skin edges to complete the ano-
formation, c Larrhoea, or constipation. The anus was in the normal posi- plasty. Postoperative wound healing was uneventful and the patient has
tion and hac normal sphincter tone. A small opening was noticed in the normal bowel activity after colostomy closure and a normal cosmetic
vestibule jus: proximal to the fourchette, and insertion of a metallic probe appearance.
established a communication between the vestibule and the anus.
A preliminary divided sigmdid colostomy was performed, followed
2 weeks later by perineal surgery. A forceps was passed from the anal
opening into the perineal canal and the canal was laid open after incising
Discussion
the perineal body (Fig. 1). The incision included skin, subcutaneous
tissue, a few fibres of external sphincter muscle, and one wall of the Perineal canal [6], or double termination of the alimentary
mucosal tracl: through which the probe passed. A clear mucosa-lined tract tract [2, 7], or anorectal-vestibular fistula without imper-
extending from the anorectum to the vestibule was noted. Starting from forate anus [7] in females is a rare malformation. This
the vestibule= end, the mucosal tract was dissected off from the underly- anomaly is seen more frequently in Asian countries, no-
tably Japan, China, and and Vietnam in addition to India
[1, 7]. Controversies exist regarding the origin of these
Corresponde,~ce to: K. L. N. Rao tracts: Although there are embryologic bases suggesting a