• Archives of Plastic Surgery
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• 제48권1호
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• pp.127-130
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• 2021

Rectovaginal fistula, which can arise after an injury to the vaginal canal or rectum, is a troublesome obstacle for patients' everyday life. In most cases, it can be covered with a local flap, but previous radiation therapy increases the recurrence rate, making it especially difficult to cure. As the application of stromal vascular fraction (SVF) obtained from enzymatically digested autologous adipose tissue has become increasingly common, several reports have advocated its effectiveness for the treatment of refractory wounds. In light of the angiogenic, regenerative characteristics of SVF, it was incorporated as a treatment option in two cases of rectovaginal fistula discussed here. As described in this report, irradiated rectovaginal fistulas in rectal cancer patients were successfully treated with SVF injection, and we suggest SVF as a feasible treatment option for cases of rectovaginal fistula that would otherwise be very difficult to cure.

• 한국임상수의학회지
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• 제35권3호
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• pp.111-113
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• 2018

A three-month-old female African buffalo born at Seoul Zoo showed signs of abdominal distension, bulging of the perineal skin, and small stool volume compared to feed intake. Upon physical examination, atresia ani with rectovaginal fistula was diagnosed. This case was subjected to surgery under inhalation anesthesia after injecting a sedative. Surgery was performed in two steps: anal reconstruction and closing the rectovaginal fistula. First, a circular skin incision was made at the end of the rectal pouch to create an anus, and then the skin of the anus and the mucous membrane of the rectum were brought into apposition by simple interrupted sutures. Second, the rectovaginal fistula was ligated on both vulval and anal side. Antibiotics were administered on every alternate day and the sutures were removed at ten days surgery under sedation. The rectovaginal communication was closed and the calf was able to urinate and defecate normally. The animal grew to become a normal adult without any complications. This is the first case report of atresia ani with rectovaginal fistula in an African buffalo, that was successfully treated by surgical intervention.

• 한국임상수의학회지
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• 제39권1호
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• pp.32-37
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• 2022

A 2-month-old intact female domestic short hair presented with physical abnormalities, including discharge of watery feces from the vagina, depression, and dehydration. The rectovaginal fistula and atresia ani type 3 were diagnosed on the vaginogram. During the anoplasty, the fistula could not be identified because the patient was too small. Instead of colotomy, feces were flushed out using a feeding tube. To prevent complications, a 1-cc syringe tip was sutured at the surgical site after the anoplasty. At the 3-month telephone follow-up after surgery, the cat was reported to have no further clinical signs.

• Archives of Plastic Surgery
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• 제47권3호
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• pp.272-276
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• 2020

Anorectal malformation or imperforate anus is a congenital anomaly of rectum and anus. Mullerian duct anomalies are abnormal development of uterus, cervix, and vagina. Imperforate anus with double uterus is extremely rare and cannot explain by normal embryologic development. Moreover, guideline in treatment is inconclusive. We report an extremely rare case of a young adult female who presented with recurrent pelvic inflammatory disease caused by rectovaginal fistula in congenital imperforate anus and didelphys uterus, and successfully neoanal reconstruction with gracilis muscle flap. Aims for treatment are closed rectovaginal fistula, and anal sphincter reconstruction. To our best knowledge, the imperforate anus with double uterus is extremely rare anomaly. Furthermore, successfully anal sphincter reconstruction with functional gracilis muscle in the imperforate anus with double uterus has never been reported in English literature.

• 한국임상수의학회지
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• 제30권5호
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• pp.376-379
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• 2013

4주령의 0.6 kg 암컷 스콧티쉬 폴드 고양이가 예방 접종을 위해 내원하였다. 신체 검사에서 수양성 분변이 질에서 나오는 것이 확인 되었고 항문은 폐쇄되어 있었다. 방사선 양성 조영 검사에서 직장질루, 확장된 결장이 확인 되었다. 영상 검사에 기초하여 Type III 의 항문 무형성과 직장 질루가 병발한 것으로 최종 진단 하였다. 수술적인 직장 질루의 폐쇄와 항문의 재건이 실시되었다. 수술 후 소화능력을 향상시키기 위해서 락툴로즈와 식이요법을 실시 하였고, 고양이는 수술 후 2주에 배변 조절이 가능해졌으며, 8개월 후 추적조사에서 합병증 없이 배변조절 상태가 유지 되었다.

• Advances in pediatric surgery
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• 제15권1호
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• pp.58-63
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• 2009

환아는 4개월부터 직장 탈출증과 심한 변비를 보였으며, 9개월에 질로부터 대변이 배출되는 증상을 나타냈으나 검사상 우측 이상 형성 콩팥 및 이소성 요관 이외 특이 소견이 없어 경과 관찰을 시행하였다. 16개월에 전신 마취하에 이학적 검사를 시행하여 누공을 확인하였고 이를 통한 대장 조영술에서 직장 중복증을 진단하여 수술을 시행하였다. 수술 시야에서 직장부터 횡행 결장에 이르는 관형의 뒤창자 중복을 확인하고, 직장-질 누공을 분리하고 결장 및 직장에는 중격절개술을 시행하였으며, 동반된 기형인 이소성 요관과 무기능 우측 신장은 절제하였다. 환아는 수술 후 3년간 잘 지내고 있다. 직장-질 누공을 동반한 관형의 뒤창자 중복은 매우 드문 선천성 기형으로 저자들의 경험을 문헌 고찰과 함께 보고하는 바이다.

• Archives of Plastic Surgery
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• 제46권3호
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• pp.277-281
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• 2019

Recto-vaginal fistulas are difficult to treat due to their high recurrence rate. Currently, no single surgical intervention is universally regarded as the best treatment option for recto-vaginal fistulas. We present a case of recurrent recto-vaginal fistula surgically treated with a gracilis pull-through flap. The surgical goals in this patient were complete excision of the recto-vaginal fistula and introduction of fresh, vascularized muscle to seal the fistula. A defunctioning colostomy was performed 1 month prior to the present procedure. The gracilis muscle and tendon were mobilized, pulled through the freshened recto-vaginal fistula, passed through the anus, and anchored externally. Excess muscle and tendon were trimmed 1 week after the procedure. Follow-up at 4 weeks demonstrated complete mucosal coverage over an intact gracilis muscle, and no leakage. At 8 weeks post-procedure, the patient resumed sexual intercourse with no dyspareunia. At 6 months post-procedure, her stoma was closed. The patient reported transient fecal staining of her vagina after stoma reversal, which resolved with conservative treatment. The fistula had not recurred at 20 months post-procedure. The gracilis pull-through flap is a reliable technique for a scarred vagina with an attenuated recto-vaginal septum. It can function as a well-vascularized tissue plug to promote healing.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권1호
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• pp.104-108
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• 1999

Currarino triad is a hereditary condition diagnosed when three abnormalities are noted: (1) an anorectal malformation; (2) an anterior sacral defect and (3) a presacral mass. We experienced 3 cases of Currarino triad with severe constipation. All cases had presacral mass and sacral bony defect. One case had rectovaginal fistula, other one case had holoprosencephaly. Presacral masses were lipomeningomyelocele and epidermoid or dermoid cyst. We report three cases of Currarino triad with brief review of the related literature.

• Archives of Plastic Surgery
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• 제45권1호
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• pp.90-92
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• 2018

• 한국임상수의학회지
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• 제16권2호
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• pp.482-485
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• 1999

45일된 암컷 English Coca Spaniel(0.65kg, 증례 1)과 60일 된 암컷 진돗개(2.05 kg, 증례 2)가 항문폐쇄증으로 내원하였다. 증례 1은 생후 5일부터 만성적인 설사를 보였으며, 내원 7일 전에 이유시켜 상업용 건사료로 바꾸었다. 내원 당시의 임상증상은 복부팽창, 식욕부진, 항문폐쇄 그리고 질 주위에 오줌과 변으로 오염되어 있었다. 증례 2는 내원 당시 우울증, 복부팽만, 항문폐쇄 등의 임상증상을 보였고 질 주위에 수양성 변으로 오염되어 있었다. 증례 1과 2에서 직장 조영술을 실시해서 직장과 질에 누공이 형성되고, 결장이 팽만되어 있음을 확인하고 수술을 실시하여 누공을 폐쇄하고 항문 형성술을 실시하였다. 증례 1은 수술직후 항문에 변이 불연속적으로 배출되었고, 2달후에는 정상적인 항문괄약근의 운동을 관찰할 수 있었다. 증례 2는 술후 4일에 식욕부진과 원기소실로 폐사하였다.