= Abstract =

A Cloacal Exstrophy Variant Associated with Hindgut Duplication

Tae Seok Lee, M.D., Sao Myung Oh, M.D.

Devision of Pediatric Surgery, College of Medicine, Kyung Hee University,

Seoul, Korea

Diphallus is a rare congenital anomaly and is frequently associated with dupli­cation of the urinary tract and rectosigmoid, and commonly associated with ver­tebral anomalies. Remzi reported less than 100 cases of duplication of all or a portion of the penis, but about 10 cases of complete diphallus with exstrophy of cloaca was reported, and a case of complete diphallus associated with hingut du­plication was reported, and complete diphallus with displacement of bladder asso­ciated hindgut duplication and imperforate anus was not reported in Korea. We experienced a case of the complete diphallus associated with displacement of bladder, hindgut duplication, and imperforate anus as a variant of cloacal exstrophy. A review of published cases suggests that this may be the first ex­ample of a complete dip hall us with displacement of bladder coexisting with the hindgut duplication and imperforate anus.

Index Words :Complete diphallus, Displacement of bladder, Hindgut duplication, Imperfor­ate anus, Cloacal exstrophy

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Fig. 1. Exrternal appearance of the patient shows double penis and completely devided scrotum. Uri· nary bladder is displaced and duplicated hindgut is prolapsed.

Fig. 2. In intravenous pyelography, both kidneys and ureters are visualized normally and single bladder is opacified in lower abdomen. But the contours of bladder is not normal.

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Fig. 3. On operation, entire bowels are distended with gas & meconium, especially sigmoid colon is markedly distended.

Fig. 4. Postoperative findings; Transverse loop co­lostomy is performed and exstrophied bladder is re­duced. Abdominal wall defect is closed primarily and double penis is not excised.

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