Gracilis transposition flap for repair of an acquired rectovaginal fistula in a pediatric patient

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Acquired rectovaginal fistulas in the pediatric population are relatively rare but are often difficult to treat. We describe a young girl who acquired a neorectovaginal fistula after a repeat pull-through procedure for Hirschsprung's disease. Durable repair of the fistula was accomplished with a gracilis transposition flap, providing a well-vascularized muscle buttress between the neorectum and vagina. To our knowledge, this is the first report of a gracilis flap in a pediatric patient with an acquired fistula and should be considered for this complication after pull-through for Hirschsprung's as well as for other perineal fistulas such as those acquired after trauma, infection, or in the setting of inflammatory bowel disease.

Original languageEnglish (US)
Pages (from-to)E37-E41
JournalJournal of Pediatric Surgery
Issue number8
StatePublished - Aug 2011



  • Gracilis transposition flap
  • Rectovaginal fistula

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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