Complex Cloacal Malformations: The Application and Importance of Cloacagrams

Abstract

Cloaca is a rare complex anorectal malformation in female patients where the urinary, gynecologic, and gastrointestinal tracts empty through a single pathway, known as the common channel. Previously, cloacas were measured through endoscopic evaluation alone. In recent years, radiographic imaging of the cloaca with a 3D cloacagram, has been a valuable tool for the characterization of the specific anatomical variables in each cloaca, and provides additional information that is beneficial for the preoperative surgical planning. This article reviews the embryology of cloaca, as well as the classification, noninvasive imaging, cloacagram protocol, and surgical intervention.