Sigmoid Colostomy

• 15-month-old baby girl with a cloaca and a very large intrapelvic sacrococcygeal teratoma
• Prior suprapubic cystostomy and sigmoid colostomy at birth

• Neonate treated in 1975--early in experience with cloacal reconstruction
• Sigmoid colostomy was done, but transverse colostomy now preferred
• Demonstrated repair in lithotomy position to be possible, although today a posterior sagittal approach might be used
• Hendren's first cloacal repair in 1962 had the vagina exteriorized with a perineal flap, and the rectum was repaired by a posterior sagittal approach and pullthrough

A 16-month-old female with complex cloacal anatomy referred in 1997. Prior sigmoid colostomy at birth.