Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap

Fistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fis...

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Main Authors: Feride Aydin, Claus Ferdinand Eisenberger, Andreas Raffel, Alexander Rehders, Stefan Benedikt Hosch, Wolfram Trudo Knoefel
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2009/676392
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author Feride Aydin
Claus Ferdinand Eisenberger
Andreas Raffel
Alexander Rehders
Stefan Benedikt Hosch
Wolfram Trudo Knoefel
author_facet Feride Aydin
Claus Ferdinand Eisenberger
Andreas Raffel
Alexander Rehders
Stefan Benedikt Hosch
Wolfram Trudo Knoefel
author_sort Feride Aydin
collection DOAJ
description Fistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fistulae (PVF). However, series only contain small numbers and an optimal management has not yet been determined. We report the case of a 26-year old woman with a third recurrence of a PVF after proctocolectomy for treatment of familial adenomatous polyposis in October 2005. Because local approaches failed, definitive closure of the fistula was achieved by interposition of a gracilis muscle flap between the pouch-anal anastomosis and the vagina. The postoperative course was uneventful; the patient was discharged 7 days after surgery and remained free of recurrence and symptomatic complaints for 22 months now. The gracilis muscle flap proved to be an effective method in the treatment of recurrent PVF.
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institution Kabale University
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spelling doaj-art-4753200604db47ec9e435281abf008d42025-08-20T03:36:46ZengWileyCase Reports in Medicine1687-96271687-96352009-01-01200910.1155/2009/676392676392Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle FlapFeride Aydin0Claus Ferdinand Eisenberger1Andreas Raffel2Alexander Rehders3Stefan Benedikt Hosch4Wolfram Trudo Knoefel5Department of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyDepartment of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyDepartment of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyDepartment of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyDepartment of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyDepartment of General Visceral and Pediatric Surgery, Heinrich-Heine University, 40225 Düsseldorf, GermanyFistulae between an ileal pouch and the vagina are an uncommon complication of ileal pouch-anal anastomosis following proctocolectomy and mucosectomy in patients with familial adenomatous polyposis coli. Several reports describe the successful use of muscle flaps to close recurrent pouch-vaginal-fistulae (PVF). However, series only contain small numbers and an optimal management has not yet been determined. We report the case of a 26-year old woman with a third recurrence of a PVF after proctocolectomy for treatment of familial adenomatous polyposis in October 2005. Because local approaches failed, definitive closure of the fistula was achieved by interposition of a gracilis muscle flap between the pouch-anal anastomosis and the vagina. The postoperative course was uneventful; the patient was discharged 7 days after surgery and remained free of recurrence and symptomatic complaints for 22 months now. The gracilis muscle flap proved to be an effective method in the treatment of recurrent PVF.http://dx.doi.org/10.1155/2009/676392
spellingShingle Feride Aydin
Claus Ferdinand Eisenberger
Andreas Raffel
Alexander Rehders
Stefan Benedikt Hosch
Wolfram Trudo Knoefel
Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
Case Reports in Medicine
title Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
title_full Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
title_fullStr Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
title_full_unstemmed Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
title_short Recurrent Fistula between Ileal Pouch and Vagina—Successful Treatment with a Gracilis Muscle Flap
title_sort recurrent fistula between ileal pouch and vagina successful treatment with a gracilis muscle flap
url http://dx.doi.org/10.1155/2009/676392
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