Case Reports

A case of persistent cloaca with interesting course of prenatal imaging

Yoshiko Usui, Kiyoshi Sasaki, Takuo Noda¹⁾
Department of Pediatric Surgery, Kochi Health Sciences Center
Department of Pediatric Surgery, Kagawa University¹⁾

Abstract

　　We report a case of persistent cloaca with interesting prenatal course. Initially fetal ascites was detected at 23 weeks of gestation. The follow up was made by sonography and magnetic resonance imaging (MRI). After 30 weeks of gestation, the ascites was diminishing, while a bicystic intrapelvic mass and bilateral hydronephrosis were arising. This sequence of prenatal findings may be characteristic of persistent cloaca. In early gestation, urine enters the abdominal cavity via the fallopian tubes, and becomes fetal ascites. In later gestation, chronic irritation with urine and meconium may cause tubal obstruction, which leads to genitourinary tract distention (hydrometrocolpos, hydronephrosis). Abdominal calcification was also observed with prenatal sonography. In cloacal anomalies, both intraperitoneal and intraluminal calcification can be formed by mixing of urine and meconium. The following prenatal US and MRI findings, transient fetal ascites, enlarging bicystic intrapelvic mass, and abdominal calcification, are important for prenatal diagnosis of persistent cloaca.

Keywords：Persistent cloaca, Fetal MRI, Fetal sonography, Hydrometrocolpos, Abdominal calcification