Yuko Tazuke, Akio Kubota, Hisayoshi Kawahara, Hiroomi Okuyama,Takaharu Oue,
Yoshiyuki Ihara, Kenji Shimada1）, Masanori Nishikawa2）
Department of Pediatric Surgery, Urology1） and Radiology2）,
Osaka Medical Center and Research Institute for Maternal and Child Health
We report a case of molimina after operation for cloacal anomaly. A 13-year-old girl had a hematometrocolpos secondary to undiscovered colpatresia, which was finally suggested by magnetic resonance imaging (MRI). She had undergone a posterior sagittal anorecto-urethra-vaginoplasty and intestinal vaginoplasty using a colon segment after Hendrenn’s method for cloacal anomaly at 2 years old. At the age of 13 years, she had abdominal pain synchronized with the menstrual cycle. Ultrasound examination (US) showed duplicate vagina and duplicate uterus and a cystic mass to the right of the neo-vagina. MRI was performed to investigate the details of her pelvic anastomosis. MRI and US showed right colpatresia associated with hematocolpos as a cystic mass. Anastomotic stenosis between the neo-vagina and the left colpos was also detected by MRI and US. To create an adequate drainage route an anastomosis between the right colpos and the neo-vagina was performed, and the left anastomotic stenosis was relieved. Cloacal anomaly includes many variations of mu¨llerian duct anomaly, and may show complicated features after surgery. MRI can provide fairly accurate information about complicated anatomy, and facilitate adequate surgery for cloacal anomaly, especially with a view to corrective surgery. Thus, preoperative MRI survey of cloacal anomaly in an adolescent helps to restore the drainage route and eventually improve fertility.
Keywords：Cloacal Anomaly, Molimina, Hematocolpos, Pubertal, MRI