AJR 2006; 187:1034-1035.
Adams ME, Hiorns MP, Wilcox DT.
Cloacal malformation is a rare anomaly occurring exclusively in genotypically female infants with an incidence of, one in 50,000 births [1]. It represents the persistence of an early stage of embryonic development in which the urinary, genital, and gastrointestinal tracts remain confluent, all draining via a common channel to a single perineal orifice. However, the range of malformation varies greatly among individual patients, and the challenge for the radiologist and urologist is to define the anatomy accurately to allow reconstruction to be planned. Conventionally, imaging has involved a series of different studies each aimed at delineating part of the complex anatomy. Often the exact configuration of the different elements only becomes apparent during surgical exploration. We report a case in which a micturating cystogram and excretory urogram were performed simultaneously with thin-section MDCT, which to our knowledge is a new technique. Subsequent reformatting allowed accurate 3D representation of all the urogenital and hind-gut components and connections, thereby greatly enhancing surgical planning.