title: Bladder duplication with one exstrophy and one cloaca.
abstract: Bladder duplication is a rare anomaly. Less than 100 cases of all types have been described in the literature. When duplication of the bladder occurs, it has previously been described as a mirror image or as a septate bladder. A newborn female presented with what appeared to be a complete bladder exstrophy, a large ruptured omphalocele with perforated large bowel, an imperforate anus, and a bifid clitoris. Urine was seen emanating from various sites: the bladder mucosa, the mucous fistula constructed at the time of the colostomy, and the left hemiclitoris. The anatomic puzzle was resolved when multiple studies disclosed the problem to be a bladder duplication. The bladder on the anterior abdominal wall was exstrophied, the intraabdominal bladder was a cloaca, and the left hemiclitoris contained a phallic urethra, which drained the intraabdominal bladder. Total correction with normal function was obtained. This patient demonstrates that bladder duplication may present in various ways.
mesh_terms: D000015:Abnormalities, Multiple / Q000473:pathology*; D001006:Anus, Imperforate / Q000473:pathology; D001746:Bladder Exstrophy / Q000473:pathology*; D002987:Clitoris / Q000002:abnormalities / Q000473:pathology; D002988:Cloaca / Q000002:abnormalities* / Q000473:pathology; D005260:Female; D006554:Hernia, Umbilical / Q000151:congenital / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000151:congenital / Q000473:pathology; D007420:Intestine, Large; D012422:Rupture, Spontaneous; D001743:Urinary Bladder / Q000002:abnormalities* / Q000473:pathology