PubMed · 308678
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S Arap, A Cabianca, E G Abrão, F A Silva, G Menezes de Góes. 1978. [Cloacal exstrophy].. https://pubmed.ncbi.nlm.nih.gov/308678/
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The sonograms of five neonates with an obstructed urogenital sinus and four with an obstructed cloaca were retrospectively reviewed to determine the sonographic features and the role of pre- and postnatal sonography in the diagnosis and management of hydrocolpos. On pre- and/or postnatal sonograms, the obstructed genital tract was visualized in seven neonates as a large cystic pelvic-abdominal mass, which was the markedly distended urine-filled vagina. One neonate had multiple cystic masses, which resulted from an obstructed duplex genital tract. In one of the neonates with an obstructed cloaca, the anomaly was not diagnosed. The bladder was compressed by the distended vagina and was not visualized in five patients. A vaginal fluid-debris level in six patients was a key finding that distinguished the vagina from the bladder. Obstruction of the urinary tract was an associated feature. An obstructed uterovaginal anomaly with renal dysplasia and oligohydramnios on prenatal sonograms indicates a poor prognosis. Sonography contributes to the diagnosis of an obstructed genital tract and helps define the internal genital anatomy.
The cloacal anomaly is characterised by the persistence of a common channel draining the urinary, genital and alimentary tracts via a single orifice. It results from abnormal compartmentalisation of features that are normal in the primitive female embryo. Abnormal embryology and cloacal anatomy are described in detail. Cloacal abnormalities are usually diagnosed promptly in the neonatal period. Management can be divided into three phases: (1) investigating and defining the anatomy, (2) neonatal intervention with relief of obstruction and (3) definitive surgical reconstruction. Successful management of the child with a cloacal abnormality remains one of the greatest challenges to the pediatric surgeon.
Two cases of cloacogenic polyp are described. These polyps have been previously reported by American authors (Lobert & Appleman 1981), but the entity has not been described in the British literature.