Balani Laveena, Kumar Ashok
Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India.
World J Clin Cases. 2025 Aug 26;13(24):107233. doi: 10.12998/wjcc.v13.i24.107233.
Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration. This is characterized by complete disruption of the perineal body, anterior defect of the internal and external anal sphincter, and loss of the distal rectovaginal and/or anovaginal septum. The common chamber incorporating vagina and recto anal outlet ensues as cloaca.
We present a case of unmarried 15-year female, who developed hematometra and was diagnosed as cervical ostia obstruction at the age of 12 year. She underwent drainage of hematometra, and later some abdominal and perineal procedures elsewhere and subsequently developed fecal discharge from the vagina. Examination revealed absence of posterior wall of vagina and anterior wall of anorectum. In addition, the anterior half of the anal sphincter was also absent. She underwent vaginoplasty, anorectoplasty, sphincteroplasty with levatorplasty with creation of rectovaginal septum.
This case report highlights expert management of a case of mismanaged benign gynaecological condition in a young female that resulted in lifelong impairment of the patient's quality of life following hysterectomy and salpingo-oophorectomy, leading to the development of a common cloaca.
创伤性泄殖腔畸形是严重产科损伤的结果，通常发生在会阴四度裂伤之后。其特征为会阴体完全断裂、肛门内外括约肌前部缺损以及直肠阴道和/或肛门阴道隔远端缺失。阴道和直肠肛门出口共同形成的腔隙即为泄殖腔。
我们报告一例15岁未婚女性病例，该患者12岁时出现子宫积血，被诊断为宫颈口梗阻。她接受了子宫积血引流术，之后在其他地方进行了一些腹部和会阴手术，随后出现阴道排粪。检查发现阴道后壁和直肠肛管前壁缺失。此外，肛门括约肌前半部分也缺失。她接受了阴道成形术、肛门直肠成形术、括约肌成形术及提肛肌成形术，并重建了直肠阴道隔。
本病例报告强调了对一名年轻女性良性妇科疾病处理不当病例的专业管理，该病例在子宫切除术和输卵管卵巢切除术后导致患者生活质量终身受损，进而发展为共同泄殖腔。
