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Media type:
E-Article
Title:
Prenatal Diagnosis of Covered Cloacal Exstrophy
Contributor:
Mallmann, Michael R.;
Reutter, Heiko;
Müller, Andreas;
Boemers, Thomas M.;
Geipel, Annegret;
Berg, Christoph;
Gembruch, Ulrich
Published:
S. Karger AG, 2014
Published in:
Fetal Diagnosis and Therapy, 36 (2014) 4, Seite 333-336
Language:
English
DOI:
10.1159/000360418
ISSN:
1015-3837;
1421-9964
Origination:
Footnote:
Description:
The authors present the case of a prenatally diagnosed covered cloacal exstrophy in a female fetus and potential differential diagnoses within the exstrophy-epispadias complex. While on prenatal ultrasound, low-set umbilicus, omphalocele, diastasis of the pubic rami, split vulva and left-sided renal agenesis were suggestive of classic cloacal exstrophy, the presence of bladder filling and the missing characteristic elephant trunk appearance of the usually prolapsing terminal ileum suggested the diagnosis of covered cloacal exstrophy. Besides urogenital anomalies, the fetus presented with an additional small muscular ventricular septal defect. Postnatal presentation showed an omphalocele with a low-set umbilicus and a directly inferior positioned large everted (exstrophic) bladder plate with low positioned ureteric orifices. The external genitalia impressed with rudimentary vulvae and hemiclitorises. An imperforate anus was present, yet bowel movements were passed shortly after birth through a small vesicointestinal fistula positioned at the lower vesical trigone. We conclude that prenatal diagnosis of covered cloacal exstrophy can be made if bladder filling is present during prenatal ultrasound, although the bladder might become exstrophic during later gestation.