title: Cloacal outlet obstruction with an ectopic ureter.
abstract: Cloacal malformation occurs in approximately 1 in 50,000 live female births. Prenatal ultrasound may lead to the diagnosis in selected cases. We report an unusual case of prenatally detected single-system hydronephrosis with a nonvisible bladder and worsening oligohydramnios. Labor was induced at 35 weeks' estimated gestational age. On physical examination, a single perineal opening was noted consistent with cloaca. Endoscopy revealed an obstructed ectopic ureter at the level of the sphincter, an undeveloped bladder and vagina, and a fistula to the rectum. A low loop cutaneous ureterostomy and right upper quadrant loop colostomy were performed. The absence of a typical fluid-filled pelvic structure may confound the prenatal diagnosis of cloaca.
authors.affiliation: Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Dodson
authors.forename: F A
authors.initials: FA
authors.lastname: Ferrer
authors.forename: S V
authors.initials: SV
authors.lastname: Jackman
authors.forename: K J
authors.initials: KJ
authors.lastname: Blakemore
authors.forename: S G
authors.initials: SG
authors.lastname: Docimo
mesh_terms: D000015:Abnormalities, Multiple / Q000601:surgery; D002988:Cloaca / Q000002:abnormalities*; D003125:Colostomy; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000209:etiology; D007231:Infant, Newborn; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000209:etiology; D011247:Pregnancy; D012003:Rectal Fistula / Q000151:congenital; D016216:Ultrasonography, Prenatal; D014513:Ureter / Q000002:abnormalities*; D014519:Ureterostomy; D001743:Urinary Bladder / Q000002:abnormalities; D014621:Vagina / Q000002:abnormalities