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