Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report
Abstract Background Rectovaginal fistula (RVF) following aluminum potassium sulfate hydrate-tannic acid (ALTA) injection therapy for hemorrhoids is a rare complication. We report the first case of RVF after ALTA injection therapy successfully treated by gluteal-fold flap. Case presentation A 49-year...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2020-07-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00925-7 |
| _version_ | 1818247796934836224 |
|---|---|
| author | Masanori Yoshimitsu Hiroyuki Egi Shogo Nagamatsu Manabu Shimomura Keishi Hakoda Masashi Miguchi Toshihiko Kohashi Masazumi Okajima Hideki Ohdan |
| author_facet | Masanori Yoshimitsu Hiroyuki Egi Shogo Nagamatsu Manabu Shimomura Keishi Hakoda Masashi Miguchi Toshihiko Kohashi Masazumi Okajima Hideki Ohdan |
| author_sort | Masanori Yoshimitsu |
| collection | DOAJ |
| description | Abstract Background Rectovaginal fistula (RVF) following aluminum potassium sulfate hydrate-tannic acid (ALTA) injection therapy for hemorrhoids is a rare complication. We report the first case of RVF after ALTA injection therapy successfully treated by gluteal-fold flap. Case presentation A 49-year-old female suffered from a fever and rectal ulcer after undergoing internal hemorrhoid treatment with a submucosal ALTA injection at a previous clinic. One week after ALTA therapy, she noted obvious passage of flatus and stool through the vagina, and was diagnosed with RVF by anoscope at another clinic. She was referred to our hospital 3 weeks after ALTA therapy. Sigmoid colostomy was performed for fecal diversion as a preliminary step for fistula repair. However, the fistula was scarred and the defect between the rectum and vagina did not improve at all. Ten months after ALTA therapy, we performed fistula repair by gluteal-fold flap. Seven months later, sigmoid-colostomy reversal was performed. The patient has experienced no RVF in the 3 years since sigmoid-colostomy reversal. Conclusions The gluteal-fold flap strategy is a useful option for severe RVF management. |
| first_indexed | 2024-12-12T15:10:24Z |
| format | Article |
| id | doaj.art-96b4608497264268a6cb818fbf6178fe |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-12T15:10:24Z |
| publishDate | 2020-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-96b4608497264268a6cb818fbf6178fe2022-12-22T00:20:38ZengSpringerOpenSurgical Case Reports2198-77932020-07-01611510.1186/s40792-020-00925-7Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case reportMasanori Yoshimitsu0Hiroyuki Egi1Shogo Nagamatsu2Manabu Shimomura3Keishi Hakoda4Masashi Miguchi5Toshihiko Kohashi6Masazumi Okajima7Hideki Ohdan8Department of Surgery, Hiroshima City Hiroshima Citizens HospitalDepartment of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima UniversityDepartment of Plastic Surgery, Hiroshima UniversityDepartment of Surgery, Hiroshima City Asa Citizens HospitalDepartment of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima UniversityDepartment of Surgery, Hiroshima Prefectural HospitalDepartment of Surgery, Hiroshima City Asa Citizens HospitalDepartment of Surgery, Hiroshima City Hiroshima Citizens HospitalDepartment of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima UniversityAbstract Background Rectovaginal fistula (RVF) following aluminum potassium sulfate hydrate-tannic acid (ALTA) injection therapy for hemorrhoids is a rare complication. We report the first case of RVF after ALTA injection therapy successfully treated by gluteal-fold flap. Case presentation A 49-year-old female suffered from a fever and rectal ulcer after undergoing internal hemorrhoid treatment with a submucosal ALTA injection at a previous clinic. One week after ALTA therapy, she noted obvious passage of flatus and stool through the vagina, and was diagnosed with RVF by anoscope at another clinic. She was referred to our hospital 3 weeks after ALTA therapy. Sigmoid colostomy was performed for fecal diversion as a preliminary step for fistula repair. However, the fistula was scarred and the defect between the rectum and vagina did not improve at all. Ten months after ALTA therapy, we performed fistula repair by gluteal-fold flap. Seven months later, sigmoid-colostomy reversal was performed. The patient has experienced no RVF in the 3 years since sigmoid-colostomy reversal. Conclusions The gluteal-fold flap strategy is a useful option for severe RVF management.http://link.springer.com/article/10.1186/s40792-020-00925-7ALTAInternal hemorrhoidsRVFGluteal-fold flap |
| spellingShingle | Masanori Yoshimitsu Hiroyuki Egi Shogo Nagamatsu Manabu Shimomura Keishi Hakoda Masashi Miguchi Toshihiko Kohashi Masazumi Okajima Hideki Ohdan Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report Surgical Case Reports ALTA Internal hemorrhoids RVF Gluteal-fold flap |
| title | Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report |
| title_full | Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report |
| title_fullStr | Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report |
| title_full_unstemmed | Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report |
| title_short | Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report |
| title_sort | gluteal fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate tannic acid injection for internal hemorrhoids a case report |
| topic | ALTA Internal hemorrhoids RVF Gluteal-fold flap |
| url | http://link.springer.com/article/10.1186/s40792-020-00925-7 |
| work_keys_str_mv | AT masanoriyoshimitsu glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT hiroyukiegi glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT shogonagamatsu glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT manabushimomura glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT keishihakoda glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT masashimiguchi glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT toshihikokohashi glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT masazumiokajima glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport AT hidekiohdan glutealfoldflaprepairofrectovaginalfistulacausedbyaluminumpotassiumsulfatehydratetannicacidinjectionforinternalhemorrhoidsacasereport |