Surgical repair of an obstetric cloaca with review of the literature.
Adult
Anal Canal
/ injuries
Cicatrix
/ surgery
Delivery, Obstetric
Fecal Incontinence
Female
Humans
Lacerations
/ physiopathology
Obstetric Labor Complications
/ physiopathology
Perineum
/ injuries
Pregnancy
Plastic Surgery Procedures
/ methods
Surgical Wound Dehiscence
/ physiopathology
Vagina
/ injuries
gastrointestinal surgery
incontinence
pregnancy
Journal
BMJ case reports
ISSN: 1757-790X
Titre abrégé: BMJ Case Rep
Pays: England
ID NLM: 101526291
Informations de publication
Date de publication:
26 Jan 2021
26 Jan 2021
Historique:
entrez:
27
1
2021
pubmed:
28
1
2021
medline:
2
3
2021
Statut:
epublish
Résumé
A complete perineal wound breakdown of a fourth degree laceration leading to a cloaca is a rare but devastating complication of vaginal childbirth. A 32-year-old primiparous woman presented with an obstetric cloaca 4 months following delivery. She underwent preoperative evaluation and, following extensive counselling, elected to proceed with operative repair. The procedure is presented in 15 well-defined steps with photos. The repair was performed in standard fashion with three supplementary steps. These included: (1) division of the rectovaginal tissue into three distinct layers; (2) attachment of these layers individually to the reconstructed perineal body and sphincter and (3) incorporation of the levator muscles into the repair. The wound healed well within 6 weeks of repair. Now 3½ years postoperatively, the patient has no faecal incontinence or sexual dysfunction and only minimal defecatory dysfunction. The discussion describes our surgical approach in the context of a review of the literature.
Identifiants
pubmed: 33500293
pii: 14/1/e234321
doi: 10.1136/bcr-2020-234321
pmc: PMC7839897
pii:
doi:
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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