The anomalous clinical anatomy of congenital pouch colon in girls

Chadha, Ritu; Choudhury, Subhasis Roy; Pant, Nitin; Jain, Vishesh; Puri, Archana; Acharya, Himanshu; Zargar, Noor Ullah; Kundal, Anjani Kumar

doi:10.1016/j.jpedsurg.2011.01.013

Cited by 12 publications

(59 citation statements)

References 28 publications

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“…[27] In contrast to “persistent cloaca,” the external genitalia appeared essentially normal with a wide posterior margin of the vestibule [Figure 6]. In newborns, there was often an appearance of folds radiating inwards and upwards from the margins of the vestibule, a “clover-leaf” appearance[24] [Figure 6].…”

Section: Anomalous Anatomymentioning

confidence: 99%

“…Examination under anesthesia (EUA) showed the confluence of urethral and vaginal openings to be either “low,” or relatively “high” with a hypospadic urethral meatus, and double vaginas, usually tilted with a wide inter-vaginal bridge [Figure 7]. [27] On EUA and endoscopy, the terminal fistula opened either in the urethra distal to the bladder neck; high in the vestibule, almost “distal urethral” [Figure 7]; or in the vestibule, closer to the perineum. [27] There was usually a short wide urethra, deficient bladder neck, small bladder, poorly developed trigone, and laterally placed ureteric orifices.…”

Section: Anomalous Anatomymentioning

confidence: 99%

“…[27] On EUA and endoscopy, the terminal fistula opened either in the urethra distal to the bladder neck; high in the vestibule, almost “distal urethral” [Figure 7]; or in the vestibule, closer to the perineum. [27] There was usually a short wide urethra, deficient bladder neck, small bladder, poorly developed trigone, and laterally placed ureteric orifices. These features were probably responsible for the high incidence of urinary incontinence (around 85%).…”

Section: Anomalous Anatomymentioning

confidence: 99%

“…All patients had a double uterus with one monocornuate uterus and vagina flanking the fistula on each side. [27]…”

Section: Anomalous Anatomymentioning

confidence: 99%

“…[2744] Significantly, in males with CPC, where descent of the Müllerian ducts plays no role in the development of the genitourinary tract, the bladder neck is normal.…”

Section: Embryopathogenesismentioning

confidence: 99%

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Congenital pouch colon

Chadha

Khan

2017

J Indian Assoc Pediatr Surg

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Congenital pouch colon (CPC) is an unusual abnormality in which a pouch-like dilatation of a shortened colon is associated with an anorectal malformation. It is categorized into four subtypes (Types I–IV) based on the length of normal colon proximal to the colonic pouch. In males, the pouch usually terminates in a colovesical fistula just proximal to the bladder neck. In girls, the terminal fistula opens either into the urethra or in the vestibule, close to the urethral opening. Girls usually have a double vagina with a wide inter-vaginal bridge, a monocornuate uterus on each side, and urinary incontinence due to a widely open bladder neck. Associated major malformations are uncommon with CPC but sometimes, especially in reports from outside India, major abnormalities are present suggesting an early, severe error in embryogenesis. The more severe Types I/II CPC can usually be diagnosed by a large gas shadow or air-fluid level on X-Ray abdomen. For all subtypes of CPC, it is preferable to preserve a segment of the pouch by fashioning a narrow colonic tube for pull-through, the technique known as coloplasty or tubular colorraphy. Girls need additional management of the genitourinary abnormalities. Postoperatively, fecal continence levels are usually poor, especially with Types I/II CPC.

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Section: Anomalous Anatomymentioning

confidence: 99%

Section: Anomalous Anatomymentioning

confidence: 99%

Section: Anomalous Anatomymentioning

confidence: 99%

“…All patients had a double uterus with one monocornuate uterus and vagina flanking the fistula on each side. [27]…”

Section: Anomalous Anatomymentioning

confidence: 99%

“…[2744] Significantly, in males with CPC, where descent of the Müllerian ducts plays no role in the development of the genitourinary tract, the bladder neck is normal.…”

Section: Embryopathogenesismentioning

confidence: 99%

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