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泄殖腔畸形:一例罕见病例报告及产前影像学回顾

Cloacal malformation: A rare case report and review of prenatal imagings.

作者信息

Huang Ge, Zheng Chang-Jun, Chu Guang-Yu, Liu Shu-Yan

机构信息

Department of Radiology.

Department of Orthopaedic.

出版信息

Medicine (Baltimore). 2020 Oct 16;99(42):e21839. doi: 10.1097/MD.0000000000021839.

DOI:10.1097/MD.0000000000021839
PMID:33080668
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7571954/
Abstract

RATIONALE

Cloacal malformation (CM) is a serious type of anorectal and urogenital tract malformation. However, prenatal ultrasound (US) detection of CM is challenging. In this paper, we reported a rare case of CM prenatally diagnosed by US and magnetic resonance imaging (MRI), as well as reviewed the prenatal US and MRI characteristics of CM in the literature.

PATIENT CONCERNS

A 30-year-old pregnant woman complained of cystic mass in the fetal abdomen detected by prenatal US.

DIAGNOSIS

Fetus CM.

INTERVENTIONS

The fetus was diagnosed as fetal CM by US and MRI, then the pregnant woman received a drug-induced labor treatment. After the neonate was delivered, the measurement was performed on the weight, length, head circumference, abdomen circumference, and bilateral thigh circumference.

OUTCOMES

A female dead neonate was delivered from the vagina of the gravida, showing congenital anus absence. Prenatal ultrasound demonstrated right kidney duplication, hydronephrosis, and right ureteral dilatation. Meanwhile, prenatal MRI showed a cystic cavity, double collecting systems of right kidney, right ureteral dilatation, and right rectum dilatation. In addition, general parameters are as follows: weight: 2280 g; length: 39 cm; head circumference: 26.3 cm; abdomen circumference: 31 cm; right thigh circumference: 17 cm, and left thigh circumference: 18 cm.

LESSONS

US combined with MRI can not only provide reliable evidence for fetal CM in the third trimester but also offer crucial information to the pregnant women to establish clinic treatment programs as early as possible.

摘要

原理

泄殖腔畸形(CM)是一种严重的肛肠和泌尿生殖道畸形。然而,产前超声(US)检测CM具有挑战性。在本文中,我们报告了一例罕见的通过US和磁共振成像(MRI)产前诊断的CM病例,并回顾了文献中CM的产前US和MRI特征。

患者情况

一名30岁孕妇抱怨产前US检测到胎儿腹部有囊性肿块。

诊断

胎儿CM。

干预措施

通过US和MRI诊断胎儿为胎儿CM,然后孕妇接受药物引产治疗。新生儿出生后,对体重、身长、头围、腹围和双侧大腿围进行了测量。

结果

一名女死婴从孕妇阴道分娩,显示先天性肛门缺失。产前超声显示右肾重复、肾积水和右输尿管扩张。同时,产前MRI显示一个囊性腔、右肾双集合系统、右输尿管扩张和右直肠扩张。此外,一般参数如下:体重:2280克;身长:39厘米;头围:26.3厘米;腹围:31厘米;右大腿围:17厘米,左大腿围:18厘米。

经验教训

US联合MRI不仅可以为孕晚期胎儿CM提供可靠证据,还可以为孕妇尽早制定临床治疗方案提供关键信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/bb1c2501166d/medi-99-e21839-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/180c4d0c7a32/medi-99-e21839-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/6e23099b27a7/medi-99-e21839-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/bb1c2501166d/medi-99-e21839-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/180c4d0c7a32/medi-99-e21839-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/6e23099b27a7/medi-99-e21839-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99e7/7571954/bb1c2501166d/medi-99-e21839-g003.jpg

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本文引用的文献

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Pediatr Radiol. 2019 Mar;49(3):387-398. doi: 10.1007/s00247-018-4302-x. Epub 2018 Dec 13.
2
Early vaginal replacement in cloacal malformation.泄殖腔畸形的早期阴道再造术。
Pediatr Surg Int. 2019 Feb;35(2):263-269. doi: 10.1007/s00383-018-4407-1. Epub 2018 Oct 30.
3
Cloacal Malformation Variant in a Male Neonate.一名男新生儿的泄殖腔畸形变体
J Indian Assoc Pediatr Surg. 2018 Apr-Jun;23(2):106-108. doi: 10.4103/jiaps.JIAPS_118_17.
4
Imaging in anorectal and cloacal malformations.肛门直肠和泄殖腔畸形的影像学检查
Pediatr Radiol. 2018 Mar;48(3):443-444. doi: 10.1007/s00247-017-4040-5. Epub 2018 Jan 23.
5
Use of 3D reconstruction cloacagrams and 3D printing in cloacal malformations.三维重建泄殖腔造影图及三维打印在泄殖腔畸形中的应用
J Pediatr Urol. 2017 Aug;13(4):395.e1-395.e6. doi: 10.1016/j.jpurol.2017.05.019. Epub 2017 Jun 20.
6
Fetal megacystis: A systematic review.胎儿巨膀胱:一项系统评价。
J Pediatr Urol. 2017 Feb;13(1):7-15. doi: 10.1016/j.jpurol.2016.09.003. Epub 2016 Oct 8.
7
Long-term urological outcomes in cloacal anomalies.泄殖腔畸形的长期泌尿系统预后
Semin Pediatr Surg. 2016 Apr;25(2):108-11. doi: 10.1053/j.sempedsurg.2015.11.010. Epub 2015 Nov 10.
8
Prenatal diagnosis of cloacal malformation.泄殖腔畸形的产前诊断。
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