Case Four: Very Complex Defect
This patient represents the most complicated type of cloaca, only to be compared with cloacal exstrophy. In this particular case, the patient was born with a very wide single opening in the perineum.
In the upper dome of that opening an orifice could be seen which communicated with the terminal ileum. The right and left colon were represented by small pieces of intestine opening in the lateral aspects of that chamber.
Both ureters seemed to be normal and also opened into this wide chamber.
Very Complex Cloaca |
The operation was an ingenious procedure in which the terminal ileum was separated from this chamber and a vagina was constructed using part of the left colon.
The right colon and the remaining portion of the left colon were used to reconstruct part of the rectum, and in an effort to preserve as much water-absorbing tissue as possible, the terminal ileum was anastomosed to this colon.
The rectal component of this repair was then located within the limits of the muscle sphincters. The patient has been doing surprisingly better than expected for this kind of defect.
The Operation |
For more information or to request an appointment, please contact the Colorectal Center at Cincinnati Children's.
