Abstract:

Perineal laceration is a common complication of vaginal delivery. Clinically, first- and second-degree perineal lacerations are more common, while the incidence of third- and fourth-degree perineal lacerations is low. Rectal buttonhole tear is a special and rare complication of vaginal delivery. This paper reports a case of rectal buttonhole tear complicated with vaginal delivery admitted to Taizhou People′s Hospital affiliated to Nanjing Medical University. During the patient′s delivery, the fetus′ arm penetrated the perineal body. After delivery, vaginal laceration repair and rectal repair were performed. Postoperatively, antibiotics were given to prevent infection, the diet structure was adjusted, and sufficient tube drainage was set for the wound. Complications such as rectovaginal fistula and wound dehiscence did not occur, and the patient was cured and discharged. The diagnosis and treatment process of this patient was retrospectively analyzed, and relevant literature was reviewed to summarize the clinical experience in the diagnosis and treatment of rectal buttonhole tear.

Key words: Obstetric labor complications, Case reports, Vaginal delivery, Rectal buttonhole tear, Perineal laceration