Imperforate Clocal Membrane의 2부검증례

Abstract

Congenital malformations of ano-recturn are relatively common and have many variation in the level of obstruction and presence or type of fistula. Ladd and Gross (1934), Wilkinson (1972) classified these anomalies and their classifications are widely used clinically and pathologically. Cheng et al. (1974) reported 5 cases of persistent cloaca with review of 50 cases reported previously. All of these cases have single perineal opening and the rectums are connected either to bladder or to vagina. Because of the fact that 362 out of 507 cases with imperforate anus have rectovaginal, rectovesical or rectourethral fistula (Gross, 1934), it is often difficult to distinguish the persistent cloaca from imperforate anus with fistula formation. And most of the fistula found in patients with imperforate anus are likely to be the unobliterated cloacal canal. We report two cases of imperforate anus of another variety that could best be understood along with imperforate cloacal membrane. These patients were deficient of both anus and urethral opening, and the bladder and rectum had free communication. Case 1 was a full-term male infant who died soon after birth. He had rudimentary phallus without opening. Midline fold of buttock was absent. No perineal opening was found. Both feet had four digits each. Abdominal cavity contained two cystic masses and two kidneys. Two ureters of the kidneys drained into one of the cysts, and the other cyst was connected to the rectum. Between these two cysts there was free communication with a large opening. Neither urethral opening nor anal opening were found in and outside the cysts. Case 2 was a baby who was delivered by Cvsection at 6 months of gestational age. External genitalia and anal canal could not be seen externally. The abdomen was markedly distended and was near-totally replaced by huge cyst containing yellowish fluid. Both ureters and rectum were connected to this huge abdominal cyst.