General Clinical Aspects

Prenatal diagnosis of persistent cloaca has been reported, but is not always accurate [12,13]. In contrast, clinical diagnosis is simple. In girls, a single opening on the perineum is always suspicious of a cloacal malformation. The length of the introitus is characteristically shorter than in a normal girl. Cloacas have only rarely been reported in boys in whom the urethra and rectum has coalesced into a common channel that is connected to the external surface in the perineal or anal area [14]. In girls, an abdominal mass and severe abdominal distension resulting from hydrome-trocolpos and/or rectal obstruction can frequently be observed. Additional malformations of the lower limbs, genitalia, skin (hemangioma), urogenital tract, vertebral, cardiac, and gastrointestinal deformities, among others may occur. A rarity is the posterior clo aca, described first by Peña and Kessler [15]. In these patients the vagina and urethra fuse together but the urogenital sinus (UGS) opens into the anterior rectal wall; the rectum is normal or minimally mislocated anteriorly. The most severe type of deformity is cloacal exstrophy, a combination of cloaca with bladder exstrophy that was first reported by Rickham in 1960 [16]. It is now called vesicointestinal fissure (see Chap. 14 for details).

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Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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