Fecal fistula

Overview fecal fistula (fecal fistula) is between genital and intestinal formation of abnormal channel. In obstetrics clinic is the most common rectovaginal fistula. Lag production fistula formation of the soiled with urine leakage sometimes. It may have small intestine, colon fistula. Genital fistula is a very painful injury diseases. As the urine and feces are not self-control, external genitals long soaking in urine, not only for women suffering physical, but for fear of patients with close to the masses, not to participate in productive work, emotional burden a great deal. Improving maternal health, conduct clean delivery, correctly handle the delivery and improve the quality of operation genital injury can be avoided. genital fistula occurred will be reduced significantly. Cause pathogenesis of fecal fistula with the basic causes of the same urine leakage, in addition, Because many of the third-degree perineal laceration suture surgery, or visit episiotomy suture thread through the mucosa caused. Small intestine, colon fistula Although rare, but more from surgery or injury caused by postoperative adhesions. Clinical manifestations if fistula hole larger and closer to the vagina mouth, forming or semi-forming stool can vaginal discharge, and the exhaust control symptoms, fecal rare when more serious symptoms. If small fistula Kong, is also relatively dry feces, feces can be no discharge from the vagina, it is only in rare side when vaginal Excess manure, However, the exhaust air is uncontrollable. If fecal fistula and urinary leakage coexist, often leak faeces or inclusions exhaust. Vaginal and vulvar frequented by faeces and with droppings and secretions stimulate genital chronic dermatitis. Rectovaginal fistula diagnosis of the symptoms of relatively simple, the diagnosis of urinary fistula easy. Fistula big hole in the vagina cpeculum exposure refers to see or touch the doctor; Fistula smaller hole was more difficult for us to see. or in the vaginal wall only to see a small red granulation tissue, such as from here with uterine probe exploration, Meanwhile the other hand fingers deep into the anus, and deep finger needle encounters may clear diagnosis. If suspected small bowel or colon vaginal fistula, with the exception of combined analysis of the history of surgery, barium may consider irrigation anal or barium meal examination. Fecal fistula treatment for the treatment of surgical repair. Patch urine leakage results than good. Its self-healing after injury have the chance to more than urinary fistula. Fresh trauma (such as surgery or injury) should immediately carry out the repair. Old fecal fistula, in the case of the higher parts of rectovaginal fistula, the provision of urinary fistula repair methods and the principles of operation, Separation fistula Kong peripheral organizations, vaginal and rectal wall separation, first slit rectum (not through the mucosa), After suture vaginal wall. If rectal vaginal wall near the anus, the first cut from the middle of anal fistulas Kong and the recto-vaginal, raising the degree perineal laceration three re-patch (Figure 1). Figure a low rectovaginal fistula repair the anterior cut anal fistula Kong and the recto-vaginal fistula case of fecal and urine leakage both. to repair the same time. If fecal fistula larger or more scar tissue, it is estimated that surgery will be difficult for the first abdominal ostomy colon and urinary fistula repair. Urinary fistula healing until after an interval of four weeks and then fecal fistula repair, so that after successful colic ostomy reduction. Although fewer such cases, the method steps to incorporate the specific circumstances of careful consideration. Rectovaginal fistula fistula huge hole, excessive scar tissue (mostly sitting corrosive vagina caused by drugs), Kong repeated fistula repair failed, as did discuss Patch no hope of success, may consider making permanent colostomy surgery. 's Diagnosis of colon or small intestine to vaginal fistula repair abdominal or intestinal resection anastomosis. Fecal fistula preoperative preparation and postoperative treatment of fecal fistula healing relations larger. Therefore, preoperative 3 ~ 5 days ever semi-liquid slag and given metronidazole 0.2 g daily 3 ~ 4 times; Served a total of three-four days. Gentamicin 80,000 U, intramuscular injection, on the 1st 2nd, with 3 ~ 4 days, or the day before serving for neomycin 1g, or daily oral streptomycin 1 g, 3 ~ 4 days, to reduce intestinal infection. Preoperative service on the 1st senna 15 g (Soaking-), or in the evening cleaning wash anal and vaginal washing. Continued after half without residue liquid diet and control defecation 3 ~ 5 days, give 5% 5ml opium tincture, three times a day; Further, such as metronidazole to prevent infection and promote wound healing. Since 4 after the date of service of liquid paraffin nightly 30-40ml, or daily service senna 15g, make thinning or stool softening easily discharge (defecation frequency can stop service). In addition, after genital should maintain cleanliness. Fecal fistula prevention prevention in the same basic urine leakage. In addition, the correct delivery and to avoid the occurrence of severe perineal laceration; Episiotomy suture thread Caution should be taken not to penetrate mucosa. Perineal suturing attention after conventional rectal palpation, a rectal mucosa found sutures removed in time. After surgery for abdominal, and pelvic floor-stripping, forced to take cover Minute sigmoid, pots and peritoneal suture they should pay attention to not penetrate the wall. In suture pelvic peritoneum, not exposed to rough surfaces, in order to avoid adhesions, infection, necrosis, overcast vaginal fistula formation.