Persistent cloaca and caudal duplication in a monovular twin, a rare case report
Name:
1-s2.0-S2210261219303244.pdf
Size:
1.275Mb
Format:
PDF
Description:
Final Published Version
Affiliation
Univ Arizona, Coll MedUniv Arizona, Div Neonatol
Univ Arizona, Steele Childrens Res Ctr
Univ Arizona, Diamond Childrens Med Ct
Issue Date
2019-06
Metadata
Show full item recordPublisher
ELSEVIER SCI LTDCitation
Cohen, Naomi & Nagy Ahmed, Mohamed & Goldfischer, Rachelle & Zaghloul, Nahla. (2019). Persistent cloaca and caudal duplication in a monovular twin, a rare case report. International Journal of Surgery Case Reports. 60. 10.1016/j.ijscr.2019.06.013.Rights
Copyright © 2019 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).Collection Information
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.Abstract
INTRODUCTION: A cloaca occurs when genitourinary tract and bowel converge into a common channel. We report a case of partial caudal duplication, persistent cloaca and vestigial appendage in a monovular female twin infant. PRESENTATION OF CASE: This is a monochorinonic-diamniotic twin born at 36 weeks with apgars of 9/9. She had a duplicated labia with two clitorises, and a partially formed accessory foot with 2 toes protruding from the right gluteal region. There was anal atresia and a punctate urethral opening in the right genitalia through which she voided spontaneously. X-ray of the accessory foot had rudimentary metatarsals and phalanges. There was left hydroureteronephrosis and a hydrocolpos causing severe mass effect. On the first day of life, she had exploratory laparotomy with a diverting colostomy and mucus fistula and drainage of hydrocolpos. At 6 months of age, she had removal of the accessory foot with flap closure of the perineal defect and vesicostomy. At 15 months of age she had laparotomy for repair of cloaca, excision of presacral pelvic mass and the duplicated vulva. DISCUSSION: Theories of etiology include failure of regression of Kovalevsky's canal (a communication that connects the amniotic and yolk sac), an incomplete form of twinning through iatrogenic damage to the zona pellucida or a failed triplet formation from a single embryo. CONCLUSION: Caudal duplication with persistent cloaca and vestigial appendage is a rare and complex malformation. Having a unified surgical and medical team to preserve quality of life and to treat complications is of key importance. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.Note
Open access journalISSN
2210-2612Version
Final published versionae974a485f413a2113503eed53cd6c53
10.1016/j.ijscr.2019.06.013
Scopus Count
Collections
Except where otherwise noted, this item's license is described as Copyright © 2019 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).