Cloacal Exstrophy: Documenting a Particular Case in Yaoundé, Cameroon

Abstract

Cloacal exstrophy in its most complex form with OEIS syndrome is characterized by the existence of an Omphalocele, Exstrophied bladder, Imperforate anus, and Spina bifida. We report a particular case of Cloacal exstrophy with OEIS complex and further birth defects. The diagnostic and therapeutic approaches, as well as difficulties encountered in a limited resource setting, are highlighted. This was a 1-day old neonate referred for the management of multiple congenital malformations, including antenatal diagnosis of malformative uropathy. On admission, the clinical findings included: a type 1 omphalocele, an anorectal malformation with a recto-urinary fistula and a covered lumbosacral dysraphism. Paraclinical examinations with cardiac and trans fontanelle ultrasound revealed associated cardiac anomaly and findings in favor of lombo-sacral dysraphism. Supportive care was given and surgical reconstruction of birth defects on day 20 was done. In conclusion, cloacal exstrophy is a rare morbid congenital polymalformative syndrome in neonates, especially when presenting with OEIS complex or syndrome. They require prompt diagnosis and immediate postnatal multidisciplinary management, with long-term follow-up for a favorable outcome.