Cloaca
Everything in the library about cloaca — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Diagnosis & Workup
4 items
Cloaca - Prental Imaging & Diagnosis - Counseling
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Dr. Todd Ponsky introduces the event. Dr. Belinda Hsi Dickie, surgical director of hemangioma and vascular malformations center at Cincinnati Children's Hospital, introduces the panel guests andbegins the event with a discussion on cloaca a
video36:15 · Nov 2018
Cloaca - Workup & Evaluation
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Dr. Manish N Patel,pediatric interventional radiologist and an associate professor of radiology, presents on complex cloacal malformations anduses of rotational Fluoroscopy and 3-D reconstruction. Dr. Patel covers topics on 3D rotational fl
video20:22 · Nov 2018
Prenatal Imaging and Counseling: Cloaca and Complex ARMs 2015
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Dr. Belinda Hsi Dickie, surgical director of hemangioma and vascular malformations center at Cincinnati Children's Hospital, introduces the panel guests and begins the event with a discussion on cloaca and other complex malformations. Topic
video31:23 · Jan 2019
Anorectal Malformation Radiology: Pediatric Colorectal Controversies 2014
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Drs Marc Levitt, Rama Jayanthi, Carlo Di Lorenzo, and Karen Diefenbach host a half day symposiumhighlighting new concepts and controversies in pediatric colorectal anomalies, primarily focusing on anorectal malformations.Discussion is based
video61:48 · Jan 2019
Surgical Management
2 items
Enhancing Urethral Meatus Creation in Cloacal Malformations: A New Technique
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Pediatric Colorectal & Pelvic Reconstruction | Children's National Hospital (childrensnational.org)
video4:41 · Aug 2025
Enhancing Urethral Meatus Creation in Cloacal Malformations: A New Technique
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Colorectal
video4:41 · Aug 2025
Complications
1 item
Complications and Long-Term Outcomes of Patients With Cloacal Malformation After Bowel Neovagina...
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Dr. Megan Reed Ivaturi from Nationwide Children's Hospital discusses a recent study published in the Journal of Pediatric Surgery on the long-term outcomes of bowel neovagina creation for patients with cloacal malformations. The study evalu
video1:05 · Jun 2026
Case-Based Learning
11 items
Cloaca - Long Common Channel
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Dr. Belinda Hsi Dickie presents a case regarding a 12 month old female with a history of cloaca and approaches to management of a long common channel. Approaches to this case werediscussed amongst the panel members. A second case was presen
video14:55 · Nov 2018
Collaborative work: Complex Pediatric Anorectal Malformations 2017
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During this session, Drs Michael Helmrath, Jason Frischer, andTodd Ponsky discuss the importance of collaborative work in complex pediatric anorectal malformation.
video23:45 · Jan 2019
Colorectal Quiz Episode 17: Cloaca Part 1
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The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the initia
podcast27:29 · Jul 2021
Colorectal Quiz Episode 18: Cloaca Part 2
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The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the operat
podcast23:10 · Jul 2021
Colorectal Quiz Episode 24: Cloaca Part 3
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The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the operat
podcast45:10 · Feb 2022
Colorectal Quiz: Episode 47
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In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of man
podcast22:19 · Jul 2026
Colorectal Quiz: Episode 47
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In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of man
podcast22:19 · Jul 2026
Colorectal Quiz: Episode 40
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In this insightful podcast, Drs. Marc Levitt, Jason Frischer, and Chris Westgarth-Taylor discuss the challenging anatomy and surgical strategies for complex fem
podcast18:43 · Jul 2026
Colorectal Quiz: Episode 40
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In this insightful podcast, Drs. Marc Levitt, Jason Frischer, and Chris Westgarth-Taylor discuss the challenging anatomy and surgical strategies for complex fem
podcast18:43 · Jul 2026
Colorectal Quiz Episode 18: Cloaca Part 2
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The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today
podcast23:10 · Jul 2026
Colorectal Quiz Episode 17: Cloaca Part 1
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The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today
podcast27:32 · Jul 2026
In-Depth Reviews
3 items
Cloaca Management with Dr. Marc Levitt & Dr. Aaron Garrison
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Marc Levitt, MD discusses Cloaca with Todd Ponsky, MD and Aaron Garrison, MDEdited by Ian C Glenn, MD and Sophia Abdulhai, MDDr. Levitt is surgical director of the Center for Colorectal and Pelvic Reconstruction as well as program director
podcast43:47 · Jan 2019
Cloaca Management with Dr. Marc Levitt & Dr. Aaron Garrison
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Marc Levitt, MD discusses Cloaca with Todd Ponsky, MD and Aaron Garrison, MDEdited by Ian C Glenn, MD and Sophia Abdulhai, MDDr. Levitt is surgical director of the Center for Colorectal and Pelvic Reconstruction as well as program director
podcast43:47 · Dec 2020
ERN eUROGEN ARM Webinar Series: Management of Cloacal Malformations – what is new in 2021?
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eUROGEN ARM Webinars Series, October 2021
This webinar will be presented by Dr. Marc Levitt from the Children’s National Hospital in Washington D.C.
The management of cloacal malformations, including prenatal diagnosis, newborn trea
video48:03 · Dec 2022
Summaries and takeaways+ Show
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Cloaca - Prental Imaging & Diagnosis - Counseling
Genital urinary anomalies and anorectal malformations represent a broad spectrum; the more severe the malformations, the higher the chances that amniotic fluid volume will be abnormal
clinicalMaria Calvos11:29 ↗
Cincinnati Children's uses a combined approach with ultrasound and fetal MRI because they are complementary techniques
clinicalMaria Calvos12:05 ↗
On ultrasound, the first structure seen from the abdominal cord insertion is the bladder, outlined by umbilical arteries (three-vessel cord) or single artery (two-vessel cord)
clinicalMaria Calvos12:50 ↗
Echogenic concretions (meconium) in the hydrocolpos or bladder are clues for rectourinary fistula and anorectal malformation
clinicalMaria Calvos13:45 ↗
Ultrasound has technical limitations: it does not provide good imaging with poor amniotic fluid, is not good at detecting early stages of cystic renal dysplasia, and not all anorectal malformations will be detected even when searching for them
clinicalMaria Calvos14:36 ↗
In the fetal bowel, the stomach and proximal bowel contain mostly fluid (bright on T2-weighted MRI), while distal bowel contains meconium (dark on T2-weighted imaging, bright on T1-weighted imaging)
clinicalMaria Calvos15:24 ↗
Meconium is not expected to reach the rectum until 20 weeks gestation and will fill the entire colonic column by 26 weeks
clinicalMaria Calvos16:23 ↗
According to Seinda and co-authors, the rectum length from bladder base to the most distal segment should measure at least 10 millimeters on sagittal view
host_summaryMaria Calvos16:44 ↗
In a Cincinnati Children's review of prenatal MRI of cloacal malformations, long common channel cloacas presented with high position of the rectum and dilatation
clinicalMaria Calvos18:02 ↗
Cloacas and imperforate anus with rectourinary fistula can have fluid distention of the rectum and enterolith-like material
clinicalMaria Calvos19:02 ↗
Increased fluid content in the rectum (bright signal instead of dark on T2-weighted MRI) is a clue for rectourinary fistula
clinicalMaria Calvos19:20 ↗
Long common channel cloacas can present with hydrocolpos and urinary ascites
clinicalMaria Calvos20:09 ↗
Urogenital sinus can present with urinary hydrocolpos and obstructive uropathy and/or ascites, but the rectum follows a normal course posterior to the bladder and is not dilated
clinicalMaria Calvos20:49 ↗
Cloacal exstrophy patients typically present with persistent absent visualization of the bladder and normal amniotic fluid, indicating urine is making its pathway out
clinicalMaria Calvos22:14 ↗
Cloacal exstrophy babies frequently have an omphalocele that is typically lower in position and can have spinal defects, typically skin-covered
clinicalMaria Calvos22:50 ↗
The prolapsed terminal ileum in cloacal exstrophy appears as a tubular structure protruding and floating in amniotic fluid, called the 'elephant trunk sign'
clinicalMaria Calvos23:05 ↗
In Cincinnati Children's review, cloacal exstrophy patients did not present meconium signal in the bowel in the expected distribution of the rectum, which is completely different from bladder exstrophy
clinicalMaria Calvos24:54 ↗
Bladder exstrophy should have a normal rectum with bright T1 and dark T2 signal, absent bladder visualization, protruding structure in infraumbilical abdominal wall, and unusual external genitalia with epispadias
clinicalMaria Calvos25:16 ↗
Dr. Peña reviewed mothers of babies born with cloacas who did not have prenatal diagnosis; when he obtained their ultrasounds, many had abnormalities but radiologists misdiagnosed them as urethrocele, double bladder, ovarian cysts, or bladder diverticulum instead of recognizing hydrocolpos
clinicalAlberto Peña30:42 ↗
If a female fetus has a prenatal diagnosis of ovarian cyst, double bladder, or urethrocele, suspect the patient may have a cloaca; if the patient also has abnormal vertebrae, hydronephrosis, and dilated bowel, that confirms the diagnosis
clinicalAlberto Peña32:15 ↗
Advantages of prenatal diagnosis include transferring the patient to a specialized center for proper colostomy and hydrocolpos drainage, and preparing the mother so she has time to digest the news and can enjoy the birth knowing the baby will go to surgery 24 hours later
opinionAndrea Bischoff32:46 ↗
For proper prenatal counseling of cloaca patients, surgeons want to know the common channel length and sacrum status, but this information is still limited in prenatal imaging
clinicalAndrea Bischoff33:30 ↗
At 20 weeks gestation when most ultrasounds are done, cloacal findings may be very subtle with nothing that tips the community obstetrician off that there's anything wrong
clinicalJack Langer35:00 ↗
Collaborative work: Complex Pediatric Anorectal Malformations 2017
The institutional environment, not the individual surgeon, is the determining factor of patient outcomes in complex pediatric cases.
opinion0:15 ↗
Effective multidisciplinary teams start with 2-3 completely dedicated practitioners and build incrementally, not with 30 members from the start.
opinionJason0:53 ↗
True collaborative care requires coordination of time: shared clinic appointments, shared OR time, and dedicated conference time (Wednesdays at 9 a.m. for one hour in this team's case).
clinicalJason1:38 ↗
The team is supported by nurses who serve as 'the glue that hold us all together' and back office staff who coordinate ORs, clinics, and conferences.
clinical2:23 ↗
The team recently added a physical therapist and behavioral medicine team as the program grew and needs expanded.
clinicalJason3:18 ↗
When a vagina is filled with fluid/urine in a cloaca, it can prohibit urine emptying and put pressure on the ureters, threatening kidney health.
clinicalLeslie8:28 ↗
Draining the vagina in hydrocolpos is primarily for kidney health and enabling urine release, not for the vagina's sake.
clinicalLeslie8:35 ↗
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