fecal fistula
Introduction
Introduction to manure Fecal fistula refers to the abnormal passage formed between the reproductive organs and the intestine. The most common form of rectal vaginal fistula in obstetrics and gynecology. Fecal fistula formed by delayed labor sometimes has urinary fistula. In addition, there may be small intestines, colonic vagina. The genital fistula is an extremely painful injury. Because of the urine, the feces can not be controlled by themselves, and the genital area is soaked in the urine for a long time, which not only brings physical pain to the women, but also the patients are afraid of being close to the masses and cannot participate in the production labor. The mental burden is also great, and the maternal health care is strengthened. The new method of birth delivery, the correct treatment of childbirth, improve the quality of surgery, genital damage can be avoided, the occurrence of genital fistula will inevitably be greatly reduced. basic knowledge The proportion of illness: 0.0025% Susceptible people: good for women Mode of infection: non-infectious Complications: urinary fistula
Cause
Fecal cause
The cause of fecal fistula is basically the same as that of urinary fistula. In addition, many of them are due to the failure of suture surgery for perineal third degree laceration, or the suture is transmitted through the intestinal mucosa when suture is performed. The small intestine and colonic vaginal fistula are less. See, but mostly caused by surgical injury or postoperative adhesions.
Prevention
Manure prevention
The prevention of fecal fistula is basically the same as that of urinary fistula. In addition, it should be correctly assisted in the production and avoid severe perineal laceration. When the perineal incision is sutured, the suture should not be penetrated into the rectal mucosa. After the perineal suture, the rectal mucosa is found. The suture is removed in time. For abdominal surgery, the pelvic floor is peeling off, and the sigmoid colon has to be covered. When suturing with the pelvic peritoneum, care should be taken not to penetrate the intestinal wall. When suturing the pelvic floor peritoneum, be careful not to expose the rough surface. In order to avoid intestinal adhesions, infection, necrosis, and formation of vaginal haze.
Complication
Fecal complication Complications
Can be complicated by vaginitis, occasionally combined with urinary fistula.
Symptom
Fecal symptoms, common symptoms , vaginal discharge
Clinical manifestation
If the pupil is larger and close to the vaginal opening, the formed or semi-formed stool can be discharged through the vagina, and there are uncontrollable exhaust symptoms. The above symptoms are more serious when the stool is thin. If the pupil is small, the stool is dry. Then there is no feces excreted from the vagina, but only when the skin is thin, the vagina overflows the feces, but the exhaust can not be controlled. If the feces and the urine are coexisting at the same time, the urine is often mixed with feces or exhausted at the same time, the vagina and the vulva are often Chronic vulvar dermatitis occurs when stimulated by feces and secretions with feces.
Examine
Manure inspection
Examination often shows that the posterior wall of the vagina has pupils, the larger ones are clearly visible, and the small ones sometimes need to be probed with a thin probe or a proctoscopy to confirm the diagnosis.
Diagnosis
Diagnosis of fecal fistula
The symptoms of rectal vaginal fistula are relatively simple, so the diagnosis is easier than urinary fistula. Large pupils can be seen under the exposure of vaginal speculum or touched at the time of finger examination; those with smaller pupils are not easy to see, or only see the posterior wall of the vagina. A bright red granulation tissue, such as a uterus probe from here, while the other hand reaches the anus, the finger and the deep needle meet to confirm the diagnosis, such as suspected small intestine or colonic vaginal fistula, in addition to the analysis of surgical history, Consider an anal or barium meal perspective.
