A Rare, Unusually Long Vestibular Fistula in a Female: Challenges Faced in Diagnosis and Management

Abstract

We present a rare case of a female neonate with a long vestibular fistula extending above the peritoneal reflection, a variant seldom described in literature. Initially, anterior sagittal anorectoplasty was attempted but it revealed an unusually long and stenotic fistulous tract, thus forcing us to do a diversion colostomy. Definitive abdominoperineal pull-through was later performed with a good postoperative outcome. Awareness of this rare anomaly is crucial as management differs significantly from typical female vestibular or perineal fistulas.

Keywords: Abdominoperineal pull-through; anorectal malformation; female anorectal malformation; long vestibular fistula; rectovestibular fistula; vestibular fistula.