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Imperforate Clocal Membrane의 2부검증례 : Imperforate Cloacal Membrane(Two Autopsy cases report)

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서정욱; 유재형; 지제근

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서울대학교 의과대학
Seoul J Med, Vol.23 No.1, pp. 137-142
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.
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