Ano-Bartholin's Gland Fistula Caused by Anal Fistula in a Patient without Crohn's Disease: A Case Report

Abstract

We report a rare case of an ano-Bartholin's gland fistula caused by an anal fistula in a patient without Crohn's disease (CD). A 34-year-old woman was admitted to our hospital due to purulent anal discharge and left vulvar pain. She had experienced several Bartholinitis in the past 2 years. She had no history of inflammatory bowel disease or other relevant conditions. A transanal ultrasound scan and pelvic magnetic resonance imaging showed a transsphincteric anal fistula connecting to an ano-Bartholin's gland abscess in the left vulva. Surgical findings showed that the primary opening of the anal fistula was located between the dentate line and anal verge. The fistula was treated with a sphincter-preserving subcutaneous incision of the fistula tract and internal sphincterotomy, and the Bartholin's gland abscess was effectively managed with drainage alone without excision. The postoperative recovery was successful, with no disturbance in defecation or sexual function. Although complex anal fistulas involving the female genital organs sometimes occur in patients with CD, they are exceedingly rare in patients without CD. This case shows that such fistulas can be managed with targeted anal fistula procedures with minimal invasion of the perineal area.