Unusual Case of Cloacal Malformation

Case Summary

• 3 mo baby girl
• Single orifice (small)
• Double barrel colostomy
• Increasing head circumference on admission – Hydrocephalus
• PMH: Was born with VACTERL
• Thoracotomy. TEF repair (day 2); Day 7 lap-assisted colostomy
• WORKUP:
  • Routine labs – NAD
  • Distal colostogram
• PROCEDURES:
  • Cystoscopy – couldn’t find vagina
  • Prone position with full-body prep with Foley introduced to distal rectum
  • Colostomy takedown (full bowel prep been done)
  • Distal rectum mobilization
  • PT of anastomosed rectum
  • PN for 10 d