ANTENATAL RUPTURE OF A DIVERTICULAR RECTAL DUPLICATION WITH NEONATAL PERINEAL FISTULIZATION

A cystic pelvic malformation was found in a fetus on antenatal sonogra phy (US) at 26 weeks of gestational age that was no longer present 3 w eeks later on control US. The male child presented at birth with a rig ht-sided perineal mass that fistulized with meconial drainage. A radio paque enema showed a low posterior rectal fistula filling a poorly del ineated pouch. Surgery performed through a posterior sagittal approach allowed identification and closure of the fistula and pouch drainage. The diagnosis of a diverticular rectal duplication was considered, al though no intestinal lining was observed macroscopically or histologic ally. The child's anorectal function was normal after a 20-month follo w-up. Labeling of the malformation and embryological hypotheses are di scussed since the case does not fulfill all the criteria of an intesti nal duplication. Surgical techniques are discussed, with an emphasis o n the sagittal posterior approach.