Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly
Abstract Background Rectovaginal fistulas represent 5% of all anorectal fistulae and are a disastrous manifestation of Crohn’s disease that negatively affects patients’ social and sexual quality of life. Treatment remains challenging for colorectal surgeons, and the recurrence rate remains high desp...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-11-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12893-017-0309-8 |
| _version_ | 1818540350956896256 |
|---|---|
| author | Gaetano Gallo Alberto Realis Luc Giuseppe Clerico Mario Trompetto |
| author_facet | Gaetano Gallo Alberto Realis Luc Giuseppe Clerico Mario Trompetto |
| author_sort | Gaetano Gallo |
| collection | DOAJ |
| description | Abstract Background Rectovaginal fistulas represent 5% of all anorectal fistulae and are a disastrous manifestation of Crohn’s disease that negatively affects patients’ social and sexual quality of life. Treatment remains challenging for colorectal surgeons, and the recurrence rate remains high despite the numerous available options. Case presentation We describe a 31-year-old female patient with a Crohn’s disease-related recurrent perineo-vaginal and recto-vaginal fistulae and a concomitant mullerian anomaly. She complained of severe dyspareunia associated with penetration difficulties. The patient’s medical history was also significant for a previous abdominal laparoscopic surgery for endometriosis for the removal of macroscopic nodules and a septate uterus with cervical duplication and a longitudinal vaginal septum. The patient was successfully treated using a Martius’ flap. The postoperative outcome was uneventful, and no recurrence of the fistula occurred at the last follow-up, eight months from the closure of the ileostomy. Conclusion Martius’ flap was first described in 1928, and it is considered a good option in cases of rectovaginal fistulas in patients with Crohn’s disease. The patient should be referred to a colorectal centre with expertise in this disease to increase the surgical success rate. |
| first_indexed | 2024-12-11T21:54:12Z |
| format | Article |
| id | doaj.art-a2d3a57a5d2d485bb1999cc390fe75a0 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-11T21:54:12Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-a2d3a57a5d2d485bb1999cc390fe75a02022-12-22T00:49:22ZengBMCBMC Surgery1471-24822017-11-011711510.1186/s12893-017-0309-8Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomalyGaetano Gallo0Alberto Realis Luc1Giuseppe Clerico2Mario Trompetto3Department of Colorectal SurgeryDepartment of Colorectal SurgeryDepartment of Colorectal SurgeryDepartment of Colorectal SurgeryAbstract Background Rectovaginal fistulas represent 5% of all anorectal fistulae and are a disastrous manifestation of Crohn’s disease that negatively affects patients’ social and sexual quality of life. Treatment remains challenging for colorectal surgeons, and the recurrence rate remains high despite the numerous available options. Case presentation We describe a 31-year-old female patient with a Crohn’s disease-related recurrent perineo-vaginal and recto-vaginal fistulae and a concomitant mullerian anomaly. She complained of severe dyspareunia associated with penetration difficulties. The patient’s medical history was also significant for a previous abdominal laparoscopic surgery for endometriosis for the removal of macroscopic nodules and a septate uterus with cervical duplication and a longitudinal vaginal septum. The patient was successfully treated using a Martius’ flap. The postoperative outcome was uneventful, and no recurrence of the fistula occurred at the last follow-up, eight months from the closure of the ileostomy. Conclusion Martius’ flap was first described in 1928, and it is considered a good option in cases of rectovaginal fistulas in patients with Crohn’s disease. The patient should be referred to a colorectal centre with expertise in this disease to increase the surgical success rate.http://link.springer.com/article/10.1186/s12893-017-0309-8Rectovaginal fistulaCrohn’s diseaseMullerian anomaliesMartius’ flapDyspareunia |
| spellingShingle | Gaetano Gallo Alberto Realis Luc Giuseppe Clerico Mario Trompetto Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly BMC Surgery Rectovaginal fistula Crohn’s disease Mullerian anomalies Martius’ flap Dyspareunia |
| title | Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly |
| title_full | Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly |
| title_fullStr | Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly |
| title_full_unstemmed | Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly |
| title_short | Martius’ flap for recurrent perineal and rectovaginal fistulae in a patient with Crohn’s disease, endometriosis and a mullerian anomaly |
| title_sort | martius flap for recurrent perineal and rectovaginal fistulae in a patient with crohn s disease endometriosis and a mullerian anomaly |
| topic | Rectovaginal fistula Crohn’s disease Mullerian anomalies Martius’ flap Dyspareunia |
| url | http://link.springer.com/article/10.1186/s12893-017-0309-8 |
| work_keys_str_mv | AT gaetanogallo martiusflapforrecurrentperinealandrectovaginalfistulaeinapatientwithcrohnsdiseaseendometriosisandamulleriananomaly AT albertorealisluc martiusflapforrecurrentperinealandrectovaginalfistulaeinapatientwithcrohnsdiseaseendometriosisandamulleriananomaly AT giuseppeclerico martiusflapforrecurrentperinealandrectovaginalfistulaeinapatientwithcrohnsdiseaseendometriosisandamulleriananomaly AT mariotrompetto martiusflapforrecurrentperinealandrectovaginalfistulaeinapatientwithcrohnsdiseaseendometriosisandamulleriananomaly |