Female Patient with Esophageal Atresia Repaired as Neonate with Cloaca (Hendren Patient Case)

Case Overview: 
  • Newborn female patient
  • Esophageal atresia repaired as neonate
  • Had cloaca
  • Loop sigmoid colostomy was done
  • Referred at age 5½ years for cloacal repair
  • Chronic spillover of stool from loop colostomy, filling vagina and bladder with reflux, severe renal scaring

 

Follow Up: 
  • Patient developed satisfactory bowel control with assistance of enema washouts
  • Self-catheterization was used for the urinary tract; patient was dry
  • Renal failure occurred late, proceeding to dialysis and renal transplantation (an aunt as donor) at age 16
  • Bleeding from the perineum began suddenly at night during sleep and she expired from it despite attempted resuscitation at a nearby community hospital
  • Ultimate course was traced to gross damage to her urinary tract by feces from her loop colostomy and a delay of 3-plus years to have her reconstruction surgery (father was in the military and moving her from her birth city to a city far away, which delayed plans for her early repair)

Journal Article(s):
Repair of Cloacal Anomalies: Current Techniques

 

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