1-Day-Old Female Patient with Recto-vaginal Tear During Cesarean Section

Case Summary

• 1-day-old female patient presented for evaluation.
• She was born via cesarean section.
• Prenatal history included gestation diabetes.
• She was identified to have a recto-vaginal tear after birth with significant bleeding. At the time of presentation, the patient had a fourth-degree recto-vaginal tear.
• Patient was taken to the operating room. Colostomy, reconstruction of the vagina and rectum were performed.
• On postoperative day 1, once the colostomy was productive with stool and she advanced to a regular diet for age.
• Foley catheter was kept in place for 6 d.
• On postoperative day 20, an anal calibration was performed with a size 12 hegar dilator.
• She was noted to have a partial dehiscence of the skin between the stomas.
• Distal colostogram showed rectal patency with a recto-vaginal fistula.

Takeaways

This patient will have good prognosis for bowel control.

This injury happened during delivery.