Case Two: Rectal Atresia, Double Rectourethral Fistula
The illustration below shows another interesting type of complex defect. This male child was born with rectal atresia. The upper rectal pouch had a rectobladder neck fistula, and the lower pouch had a rectourethral bulbar fistula. Thus, both upper and lower pouches were connected to the urinary tract.
Rectal Atresia |
In addition, the patient had bilateral ectopic ureters opening at the level of the bladder neck. The patient had severe associated upper urinary tract abnormalities.
The posterior sagittal approach was very successful in the repair of the rectourinary component of this defect. The upper pouch was successfully separated from the bladder neck and the lower pouch was separated from the bulbar urethra.
Both fistulae were closed and both rectal pouches were sutured together.
The muscle reconstruction was carried out in the usual manner. Unfortunately, this patient proved to have Hirschsprung's disease in addition to all these defects, and that required further specific treatment.
Muscle Reconstruction |
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
