Case: Prenatal diagnosis of Cloacal Malformation 1_… · • anhydramnion. Postnatal MRI...
Transcript of Case: Prenatal diagnosis of Cloacal Malformation 1_… · • anhydramnion. Postnatal MRI...
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Case:PrenataldiagnosisofCloacalMalformation
1KynčlM.,1HolubováZ.,1MaslavaD., 2ŠkábaR.,1Departmentof Radiology,2Departmentof Pediatric SurgerySecond Faculty of Medicine,CharlesUniversityinPrague
and MotolUniversityHospital
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Anamnesticdata
• IUGR• anhydramnion• prenatal ultrasound >cystic tumor
>MRIin37th gestational week >>diagnosis of cloacal malformation
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PrenatalMRI- cloacalmalformation
hydrocolposrectum
hydronephrosis
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PrenatalMRIfindings
• midlinepelviccysticmass>vaginabisepta,bilateralhydrocolpos,uterusduplex
• bilateralhydroureteronephrosis• slightlyabnormalmeconiumsignal(alteredbysuspectedinfluxof
urine)• commonchanneloflengtharound5cm• smallbladder• anhydramnion
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PostnatalMRIgenitography- highcloacalmalformation
withinstillationofgadoliniumintocolostomy
hydrocolposrectum
rectalfistulacommonchannel
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PostnatalMRIfindings
• vaginabisepta,bilateralhydrocolpos,uterusdidelphys• hydroureteronephrosis• commonchanneloflengtharound5cm• hypoplasticpelvicfloormuscles• normalspine
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MRIgenitography- highcloacalmalformation
hydrocolposrectum
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DistalPressureColostogram- highcloacalmalformation
hydrocolposrectum
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HighcloacalmalformationPSARPVUP20.01.14(Posteriorsagittalanorectovaginourethroplasty,pullthrough)confirmedtheprenataldiagnosis• shortrectalpouchwasexcized• colonwaspulleddowntoneoanus• divertingileostomywasdone
Shehasregularbowelmovements,passes6stoolsdailyandhasnoevidenceofneurogenicbladdersofar
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Conclusion
PrenatalandpostnatalMRIexaminationprovedtobesimilarlypreciseinanatomicaldescriptionofthehighcloacalmalformation
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Thankyouforyourattention