Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Virtual Pediatric Hospital: Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology: Case 28

Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology

Case 28

Michael P. D'Alessandro, M.D.,
Steven J. Fishman, M.D.,
Deborah E. Schofield, M.D.

Peer Review Status: Internally Peer Reviewed
Chief Complaint:
Eleven month old female with a single perineal opening.

Clinical History:
This patient was an 11 month old female with a very extensive cloacal malformation including absent anus and rectum, high rectal-vesical fistula, atresia of two vaginas, bilateral ectopic ureters, and right hydronephrosis. The patient's surgical history is remarkable for prior right colostomy with prolapse.

Clinical Physical Exam:
Single perineal opening.

icon gif icon gif Images 1 and 2

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Cloacal malformation

Imaging Findings:
An abdominal film showed multiple vertebral anomalies in the sacrum. A cloacal study demonstrated a rectovesical fistula, a long urethra-urogenital sinus, and a possible rudimentary vagina. An MRI (not shown) showed the conus medullaris to be at L1-L2, and the sacrum to be dysplastic. A pelvic ultrasound (not shown) showed a uterus and ovaries.

icon gifImage 3

icon gif icon gif icon gif Images 4, 5. and 6

Imaging Differential Diagnosis:
Cloacal malformation

Operative Findings:
At 11 months of age the patient underwent an extensive cloacal reconstruction lasting 15 hours including reduction of the prolapsed right colon, take down of the high retrovesical fistula, pull-through of the colon to the perineum to create an anus and rectum, a cut back of the urogenital sinus, cross trigone reimplantation of both ureters, creation of a small bowel vagina from ileum, right hysterectomy, left partial hysterectomy and anastomosis of upper left uterus to small bowel vagina, revision of the right colostomy, and revision of the left colostomy.

Pathological Findings:
None

Final Diagnosis:
Cloacal Malformation

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.

Similar Cases:
Case 35, Case 51

References:
None

Title Page


Follow us on Twitter @pedseducationTwitter icon and @pedsimagingTwitter icon

Additional pediatric resources: SearchingPediatrics.com | PediatricEducation.org Facebook iconTwitter iconRSS icon | GeneralPediatrics.com | Pediatric Commons


Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.