Cloacal outlet obstruction with an ectopic ureter.
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.
Dodson
J L
JL
Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
Ferrer
F A
FA
Jackman
S V
SV
Blakemore
K J
KJ
Docimo
S G
SG
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