Cloacal malformations in the pediatric surgery department of Fez

Abstract

Introduction: Cloacal malformations, which exclusively occur in females. These anomalies are rare. The immediate prognosis depends mainly on the severity of the associated malformations and relies on the quality of the surgical repair. Patients and methods: This is a retrospective descriptive study of 5 patients managed in the pediatric surgery department of the Hassan II University Hospital of Fez, during a 13-year period from January 2008 to January 2021. Results: The diagnosis is made postnatally following systematic clinical examination in the delivery room, with only one case presenting with intestinal obstruction. The malformative assessment revealed: One case with cardiopathy, abnormal renal ultrasound findings in 3 cases (predominantly uretero-pyelocaliceal dilation), and spinal anomaly found in 2 cases, and abnormal MRI findings in 3 cases, while not performed in 2 cases. Four contrast studies were performed after colostomy, revealing 2 rectovesical fistulas and 2 bilateral VUR (vesicoureteral reflux). Immediate postoperative course was uneventful, with no dehiscence, stenosis, or obstruction noted. One patient died due to cardiac decompensation at 3 months of age. Long-term evolution was characterized by the presence of anal incontinence. Conclusion: Cloacal malformation is a serious pathology, it can frequently lead to functional and vital prognosis without forgetting the psychological one. The prognosis depends mainly on the quality of management and the presence of associated malformations.