Simultaneous development of ulcerative colitis in the colon and sigmoid neovagina

Toni Webster, Heather Appelbaum, Toba A. Weinstein, Nelson Rosen, Ian Mitchell, Jeremiah J. Levine

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Vaginoplasty using sigmoid colon is a common technique for creation of a neovagina. However, special consideration must be given to potential long term consequences of using a colonic conduit for vaginal replacement. We report on the youngest described case in which a patient developed ulcerative colitis refractory to medical therapy with simultaneous involvement of a sigmoid neovagina requiring total proctocolectomy and neovaginectomy. A 17 year old XY female with a history of gonadal dysgenesis and sigmoid graft vaginoplasty presented with a history of bloody, mucoid vaginal discharge, abdominal pain, bloody diarrhea and weight loss. Colonic and neovaginal biopsies demonstrated active colitis with diffuse ulcerations, consistent with ulcerative colitis. Despite aggressive immunosuppressive treatment she had persistent neovaginal and colonic bleeding requiring multiple transfusions, subtotal colectomy and ultimately completion proctectomy and neovaginectomy. It is imperative to recognize that colectomy alone may be an inadequate surgical intervention in patients with ulcerative colitis and a colonic neovaginal graft and that a concomitant neovaginectomy may be integral in providing appropriate treatment.

Original languageEnglish (US)
Pages (from-to)669-672
Number of pages4
JournalJournal of pediatric surgery
Volume48
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

Keywords

  • Colitis
  • Neovaginectomy
  • Sigmoid neovagina
  • Ulcerative colitis

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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