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Case:PrenataldiagnosisofCloacalMalformation
1KynčlM.,1HolubováZ.,1MaslavaD., 2ŠkábaR.,1Departmentof Radiology,2Departmentof Pediatric SurgerySecond Faculty of Medicine,CharlesUniversityinPrague
and MotolUniversityHospital
Anamnesticdata
• IUGR• anhydramnion• prenatal ultrasound >cystic tumor
>MRIin37th gestational week >>diagnosis of cloacal malformation
PrenatalMRI- cloacalmalformation
hydrocolposrectum
hydronephrosis
PrenatalMRIfindings
• midlinepelviccysticmass>vaginabisepta,bilateralhydrocolpos,uterusduplex
• bilateralhydroureteronephrosis• slightlyabnormalmeconiumsignal(alteredbysuspectedinfluxof
urine)• commonchanneloflengtharound5cm• smallbladder• anhydramnion
PostnatalMRIgenitography- highcloacalmalformation
withinstillationofgadoliniumintocolostomy
hydrocolposrectum
rectalfistulacommonchannel
PostnatalMRIfindings
• vaginabisepta,bilateralhydrocolpos,uterusdidelphys• hydroureteronephrosis• commonchanneloflengtharound5cm• hypoplasticpelvicfloormuscles• normalspine
MRIgenitography- highcloacalmalformation
hydrocolposrectum
DistalPressureColostogram- highcloacalmalformation
hydrocolposrectum
HighcloacalmalformationPSARPVUP20.01.14(Posteriorsagittalanorectovaginourethroplasty,pullthrough)confirmedtheprenataldiagnosis• shortrectalpouchwasexcized• colonwaspulleddowntoneoanus• divertingileostomywasdone
Shehasregularbowelmovements,passes6stoolsdailyandhasnoevidenceofneurogenicbladdersofar
Conclusion
PrenatalandpostnatalMRIexaminationprovedtobesimilarlypreciseinanatomicaldescriptionofthehighcloacalmalformation
Thankyouforyourattention