2-Year-Old Female Patient Referred for Cloacal Repair (Hendren Patient Case)

Case Overview: 
  • 2-year-old female patient referred for cloacal repair in November 1981
  • No prior surgery except endoscopic and radiographic assessment of her cloacal anomaly
  • Normal chromosome study
  • On catheter drainage for several months as infant
Follow Up: 
  • Child made an uneventful recovery
  • She had normal urinary control and bowel control
  • At age 23 years in 2002, she noted noting urine draining from the umbilicus
  • Her original physician applied silver nitrate, although suspecting an urachal sinus
  • She moved to another rural area
  • In 2011, after a diligent search, the family was successfully located
  • Umbilical leakage recurred during each pregnancy but stopped postoperatively
  • It was suggested that:
    • Communication should be improved, and
    • If any leakage recurs seek treatment for a probable small urachal tract

In retrospect, this patient today would possibly be operated upon in the posterior sagittal mode, although simple lithotomy sufficed for her. Every cloaca case should be prepped and draped to make possible laparotomy, lithotomy, or prone position and should be done by a team or an individual who has experience with this often complex surgery.

Publications & Educational Resources:
Further Experience in Reconstructive Surgery for Cloacal Anomalies

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