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Background <p>Anorectal malformations (ARMs) represent a spectrum of congenital anomalies involving the distal anus, rectum, and urogenital tracts. A rectouterine fistula is an extremely rare variant in females, with limited reports and no standardized management approach, particularly in low-resource settings.</p> Case presentation <p>We report a 7-day-old female neonate with imperforate anus and intestinal obstruction. Clinical evaluation and surgical exploration revealed a high-type ARM with a fistulous connection between the rectum and uterine body, classified according to the Krickenbeck system as a rare variant of a fistula to the female genital tract. The initial management involved laparotomy, fistula ligation, and formation of an end colostomy. The postoperative recovery was uneventful. The patient was scheduled for a definitive pull-through anorectoplasty after 9–12 months, once growth and nutritional status improved.</p> Conclusion <p>This case represents one of the few documented examples of congenital rectouterine fistula in the neonatal period. A staged surgical approach remains safe and effective in resource-limited settings. Early diagnosis, multidisciplinary collaboration, and individualized surgical planning are crucial for optimal outcomes.</p>

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Unusual variant of anorectal malformation with rectouterine fistula: a rare congenital anomalies, management and review of literatures

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月8日

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  • Rajabu Athumani Bakari,
  • Alfred Chibwae,
  • Nelson Tumain Eliaman,
  • Mohammed Sultan Salim,
  • Masawa K. Nyamuryekung’e,
  • Victor T. Ngotta

摘要

Background

Anorectal malformations (ARMs) represent a spectrum of congenital anomalies involving the distal anus, rectum, and urogenital tracts. A rectouterine fistula is an extremely rare variant in females, with limited reports and no standardized management approach, particularly in low-resource settings.

Case presentation

We report a 7-day-old female neonate with imperforate anus and intestinal obstruction. Clinical evaluation and surgical exploration revealed a high-type ARM with a fistulous connection between the rectum and uterine body, classified according to the Krickenbeck system as a rare variant of a fistula to the female genital tract. The initial management involved laparotomy, fistula ligation, and formation of an end colostomy. The postoperative recovery was uneventful. The patient was scheduled for a definitive pull-through anorectoplasty after 9–12 months, once growth and nutritional status improved.

Conclusion

This case represents one of the few documented examples of congenital rectouterine fistula in the neonatal period. A staged surgical approach remains safe and effective in resource-limited settings. Early diagnosis, multidisciplinary collaboration, and individualized surgical planning are crucial for optimal outcomes.