2009 Volume 45 Issue 2 Pages 211-214
We report a rare association of covered cloacal exstrophy with penile agenesis and short bowel as the first case in Japan. A male infant was born at 32 weeks gestation weighing 1,444g. He was noted to have an imperforate anus and anomaly of the external genitalia. He had a lowset umbilicus and passed meconium via the urachus. The pubic bones were separated, but the lower abdominal wall was normal. He had aphallia and bifid scrotum. Laparotomy revealed a ileovesical fissure between the posterior extrophied bladders. Duplicated appendices and colons ended blindly approximately 4cm distal to the fistula. The small intestine was only 14cm in length from the Treitz ligament. The terminal ileum was divided from the bladder for the reconstruction of an end colostomy. The bladder was repaired with a vesicostomy made at the umbilical site.
