Vaginal discharge when loose stools

Introduction Vaginal discharge is one of the symptoms of fecal fistula. Fecal fistula refers to the abnormal passage formed between the reproductive organs and the intestine. The most common form of rectal vaginal fistula in obstetrics and gynecology.

Cause

The cause of fecal fistula is basically the same as that of urinary fistula. In addition, many of them are due to the failure of suture surgery for perineal third-degree laceration, or the suture is transmitted through the intestinal mucosa when sutured with perineal incision. Although small intestine and colonic vaginal fistula are rare, they are often caused by surgical injury or postoperative adhesion.

an examination

Related inspection

Anal finger examination blue test

(1) Clinical manifestations

Symptom

If the pupil is large, the stool and the exhaust can not be controlled, and all of them are leaked through the vagina; those with smaller pupils can be controlled when draining, and the loose stools and exhaust can not be controlled. Chronic inflammation often occurs in the vulva and vagina as a result of fecal and fecal secretions.

2. Signs

The pupils can be seen by exposing the posterior wall of the vagina. There are often granulation tissue around, and sometimes the rectal mucosa can be turned into the vagina.

(2) Auxiliary inspection

1. Probe examination: probe from the granulation to the rectum with the probe, and the other finger into the rectum. If the two meet, the diagnosis can be confirmed.

2. Methylene blue test: Inject the methylene blue solution into the rectum and fill the gauze with gauze. If the gauze is dyed with blue, it indicates the presence of the pupil.

Differential diagnosis

1. Anal external sphincter rupture: the external anal sphincter starts from the dorsal aspect of the tailbone and the anal talus ligament, which is forward and downward, and is divided into two parts at the back of the anus, around the anal canal to the front of the anus, and combined into two. In the perineum. The external sphincter is divided into three parts: the lower part of the skin, the shallow part and the deep part. The lower part of the skin is generally identifiable. There is no obvious dividing line between the shallow part and the deep part, which is difficult to distinguish, but the former is elliptical and the latter is round. The two are different in appearance. The external anal sphincter is innervated by the anal nerve. It has an important role in circumventing the anus and controlling bowel movements. If it is accidentally injured during surgery, it can cause incontinence. An external sphincter rupture can destroy the function of the external anal sphincter, leading to fecal incontinence.

2, anal fissure: anal fissure is a small ulcer formed after the laceration of the anal canal skin layer below the dentate line. Its direction is parallel to the longitudinal axis of the anal canal, and the length is about 0.5 to 1.0 cm. It is usually fusiform or oval, causing severe pain. It is difficult to heal. The anal canal surface laceration can not be regarded as anal fissure due to rapid self-healing, and often asymptomatic. Anal fissure is a common anal canal disorder and a common cause of severe pain in the anal canal in young and middle-aged people. Anal fissure is most common in middle-aged people, but it can also occur in the elderly and children. The average male is slightly more than female, but there are also reports of more women than men. Anal fissure often occurs in the back of the anus, in the middle of the front, mostly in the back of the anus, and less on both sides. From the beginning, there is only a small gap in the skin of the anal canal, sometimes it can be split into the subcutaneous tissue or until the shallow layer of the sphincter. The slit is linear or prismatic. If the anus is opened, the wound surface of the breach is round or elliptical.

3. Drainage-like bloody stool: refers to the gastrointestinal function damage caused by certain infectious factors, gastrointestinal mucosa is damaged or diarrhea and bloody stools caused by other causes, thus affecting the normal function of the human body.

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