Pediatric and Developmental Pathology

, Volume 8, Issue 3, pp 339–354

Association of Cloacal Anomalies, Caudal Duplication, and Twinning

Authors

    • Department of Laboratories (A-6901)Children’s Hospital and Regional Medical Center
    • Department of PathologyUniversity of Washington
  • Joe C. Rutledge
    • Department of Laboratories (A-6901)Children’s Hospital and Regional Medical Center
    • Department of Laboratory MedicineUniversity of Washington
  • Raj P. Kapur
    • Department of Laboratories (A-6901)Children’s Hospital and Regional Medical Center
    • Department of PathologyUniversity of Washington
Article

DOI: 10.1007/s10024-005-1157-6

Cite this article as:
Siebert, J.R., Rutledge, J.C. & Kapur, R.P. Pediatr Dev Pathol (2005) 8: 339. doi:10.1007/s10024-005-1157-6

Abstract

Cloacal anomalies exhibit a wide variety of morphologic types and accompanying clinical severity. The association of malformations of the cloaca with partial, complete, or conjoined twinning has been appreciated for some time, but, with the advent of prenatal ultrasound technology, appears to occur with a greater frequency than once thought. This observation has important implications for pathogenesis. We present 2 representative cases, a 19-week-old female fetus with duplication of several caudal structures and a 21-week-old male fetus with cloacal exstrophy variant and demised co-twin with lower abdominal wall defect, extruded intestinal tract, absent external genitalia, and imperforate anus. These findings and previously published theories suggest that certain models of monozygotic twinning may apply to the pathogenesis of cloacal anomalies. Specifically, the partial or complete duplication of the organizing center within a single embryonic disc may increase the risk of mesodermal insufficiency and thus account for the failure of complete development of the cloacal membrane and consequent exstrophy or other aberration.

Keywords

cloacaconjoined twinexstrophyparasitic twinpartial twintwin

Copyright information

© Society for Pediatric Pathology 2005