cloaca eversion
Introduction
Introduction to cloaca eversion The cloaca valgus is the least common, the most serious congenital anomaly, also known as the bladder and intestinal fissure. In males, the junction of the bladder and urethra is connected to the rectum, and the female bladder, the urethra and the vagina and the rectum are connected. Children with urinary tract from the urethra, vagina and rectum, often accompanied by severe deformities of multiple organs, most of the babies can not survive after birth, treatment is difficult, the main surgery to repair the urinary tract, intestine, abdominal wall and external genitalia, the effect is not good. basic knowledge The proportion of illness: 0.005% Susceptible population: newborn Mode of infection: non-infectious Complications: spina bifida
Cause
Cause of cloaca valgus
(1) Causes of the disease
The cloaca valgus is caused by the large cloaca membrane separating the cloaca into the anterior urogenital sinus and the posterior sinus anterior sinus rupture (Fig. 1), communicating with the rectum at the junction of the male bladder and urethra, and at the vaginal discharge of the female bladder. Or) the vaginal vaginal part communicates with the rectum. In the valgus tissue, the middle is the intestinal mucosa, the bladder mucosa is on both sides, the upper edge is connected like a hoof, and each has a ureter, the eversion of the intestine resembles the cecum, and the patient is from the rectum. The urethra and/or vagina discharge urine, feces and gas.
(two) pathogenesis
The primary defect of this disease is the formation of the umbilical lower mesenchymal tissue, the cloaca septum and the early mesoderm developmental disorders of the lumbosacral vertebrae.
1. The cloaca separation fails to form a permanent cloaca with a ureter, ileum and a residual posterior intestine opening.
2. The cloaca membrane disappeared completely, accompanied by cloaca valgus, genital knot and pubic symphysis failed to merge, and often had umbilical hernia.
3. The dysplasia of the lumbosacral vertebrae is accompanied by the expansion of the spinal cord, forming a central sacral spinal cord (spontaneous hydrocephalus), which produces a soft, cystic, skin-covered mass, sometimes asymmetrical, residual The intestines can contain two appendixes, but there is no anal opening, the small intestine may be short, men often have cryptorchidism, the female Müllerian tube is not fused, there is a complete double-horned uterus, a short, repeated or locked vagina.
Prevention
Cloaca valgus prevention
The disease is a congenital disease and there are no effective preventive measures.
Complication
Cloaca valgus complications Complications spina bifida
This disease is most often associated with spina bifida and double-cavity veins. Soper analyzed a group of cloaca valgus infants, except for pelvic malformations, about 50% with medullary bulge, umbilical bulge, and double-lumen vein, a group Of the 29 male newborns, 8 had no penis, 19 had no scrotum, 15 had double penis, and 8 had scrotal division. Of the 24 female newborns, 14 had no clitoris and 7 had clitoris.
Symptom
Ventilation eversion symptoms Common symptoms Bladder bulging bowel deformation
After birth, the child is found to have bladder, bowel valgus, umbilical bulge, urine from the rectum, urethra and/or vagina, feces and gas, valgus tissue, middle intestinal mucosa, bladder mucosa on both sides, male The lack of penis is absent, the scrotum is absent, the double penis is divided, the scrotum is divided; the female may have a lack of clitoris, the clitoris is divided, in addition, the pelvic deformity, skeletal abnormalities, spinal cord bulging, and double vena cava may be combined.
Examine
Cloaca valgus inspection
1.B-ultrasound check for abnormalities of liver, kidney, spleen, pancreas and other substantial organs.
2. X-ray examination of the pelvic plain film, the right lateral slice of the spine to check for pelvic deformity and spinal deformity, intravenous urography can show other abnormalities of the urinary system and the presence or absence of upper urinary tract obstruction.
Diagnosis
Diagnosis of cloaca valgus
Due to multiple organ malformations, most babies cannot survive for a long time after birth. According to the symptoms, the signs can be diagnosed. B-ultrasound and CT examination can help to understand whether there are other organ malformations.
Bladder valgus: the lower abdomen tissue is everted, but there is no valgus in the intestine, and there is urine in the valgus tissue.
