WOFAPS 2025 8th World Congress of Pediatric Surgery

Ubaidullah khan, Mansour ejaz, huma sardar

Farooq Hospital Islamabad

Cloacal Malformation Variant; case report

Introduction: Cloaca malformation is a rare entity and We are reporting a very rare case of cloacal malformation variant in a 13-month-old female who presented with abnormal perineum swelling, absent anal opening along with two orifice at perineum from where passage of urine and meconium took place at birth and then colostomy done at neonatal age.

Case report: A 13 months old female patients presented with a huge swelling at perineum along with two parallel orifice apart from each other on both side and split folds , mass was soft and hang over the both orifices , also anal opening is absent. Colostomy was done at neonatal age and passing stool with no other major abnormality.

Contrast study was done which show colonic path but could not well highlight other orifices, ultrasound documented all structures well at pelvis, and MRI lower spine could not show any abnormality.

Cystoscopy/vaginoscoy done which show all both external orifices combine at 2 cm from centeral and 5 cm from lateral orifice then divide into vagina, urethra with high colon ending.

Then reconstruction was plan and full repair was done from perineum, Posterior sagittal anorectalplasty urethroplasty and vaginoplasty with good recovery.

Conclusions: The essential technical point for repair is to work as team, like along with pediatric urologist and gynecologist. Cloaca presentation is some time challenging and full reconstruction is very difficult.