Traditional Remedy Gone Wrong: A Case of Rectovaginal Fistula in an Infant Due to Cultural Healing Practices.

Background: Traditional medicine remains prevalent in Somali culture, often influencing healthcare decisions. One such practice involves inserting solid salt ("Cusbo") into the anus to treat constipation. While commonly believed to be safe, this practice may contribute to severe complications, such as rectovaginal fistula (RVF).

Case presentation: A 1-year, 6-month-old female presented with persistent stool incontinence for one year. History revealed prolonged constipation treated with repeated salt insertions per traditional healing practices. Over time, the mother observed stool passage through the vagina, leading to medical evaluation. A dye test confirmed a midvaginal RVF. Surgical repair was performed using a transvaginal approach, with successful postoperative recovery.

Discussion: RVF typically results from obstructed labor, gynecological surgery, or malignancy, with foreign body insertion being a rare cause. Cultural remedies, such as salt insertion, may contribute to fistula formation, highlighting the need for awareness and preventive education. Diagnosis involves clinical examination and imaging, with surgical intervention often required.

Conclusion: This case underscores the impact of traditional practices on health outcomes. While cultural beliefs shape healthcare behaviors, awareness and education are essential in preventing complications. Clinicians must remain vigilant in recognizing such cases and ensuring timely intervention.