Reconstruction of recto-vaginal injury resulting from puerperal psychosis in a twelve year old girl

Abstract

Background: The aetiology of recto-vaginal injuries in pre-pubertal and pubertal girls varies depending on circumstances and geography. The most common aetiology in Africa is sexual abuse. The objective of this paper is to present a previously undocumented case of recto-vaginal injury which was secondary to trauma that was inflicted by a mother suffering from puerperal psychosis.
Methods: Report of a 12-year old girl with recto-vaginal injury inflicted by her own mother suffering from puerperal psychosis. A review of the literature on this unusual presentation was carried out.
Results: The patient had one stage recto-vaginal reconstruction without faecal diversion which healed without complications.
Conclusion: Maternal physical abuse is a differential aetiology of recto-vaginal injury in young girls. Recto-vaginal reconstruction without faecal diversion is a plausible treatment option in most cases because it reduces the morbidity. 

Keywords: recto-vaginal, faecal diversion, reconstruction, puerperal psychosis