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Congenital Recto-Cutaneous Fistula - Abstract

Jonathan Durell, Andrew Gordon, Kokila Lakhoo

 

Abstract

Congenital recto-cutaneous fistula is an uncommon finding in the paediatric population. The pathophysiology of these fistulas is not entirely understood. We present an interesting case of congenital recto-cutaneous fistula. A newborn female was found to have a pit at the inferior gluteal-fold. MRI defined a tract leading to the rectum. At six months and two years of age the fistula became symptomatic and on both occasions she recovered with conservative treatment. Repeat MRI at two years of age demonstrated the fistula tract shortened. At 5 years old the child required drainage of a buttock abscess. Examination could not demonstrate an internal fistula opening. A third MRI demonstrated a persistent tract, which was excised under ultrasound guidance. Histopathology reported a squamous epithelial-lined tract surrounded by chronic inflammation. Congenital recto-cutaneous fistula is an interesting yet not fully understood pathology and we present a case that adds to the complexity of the anomaly.

Keywords: congenital recto-cutaneous fistula, fistula tract

 

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