Congenital rectovaginal fistula with anorectal agenesis: A rare anorectal malformation

BACKGROUND: Rectovaginal fistula is a rare type of anorectal malformation; the incidence being less than 1%. We describe five cases of rectovaginal fistula managed at our institution. MATERIALS AND METHODS: Case records of five female neonates with rectovaginal fistula managed at our institute between 2010 and 2016 were reviewed and analysed with respect to age at presentation, clinical presentations, physical findings, investigations, management and outcome. RESULTS: The age at presentation varied from 1 day to 2 years of age. Three of them presented in the neonatal period, one presented at 1 month of age and one at two years of age with sigmoid loop colostomy done elsewhere. All had absent anal opening; two neonates passed small amounts of stools through vagina, but little in amounts. The one-month old patient had history of passing stools through vaginal orifice, but had presented to us with obstruction. All patients underwent high sigmoid loop colostomy followed by definitive procedure at a later date – Posterior Sagittal Anorectoplasty. One patient is awaiting definitive repair. CONCLUSION: Rectovaginal fistula is a rare anorectal malformation and needs thorough investigation and appropriate management for good outcome.