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The distal part of the crocodilian phallus consists of a bulbous glans containing well-developed vascular tissues that can inflate before or during sexual activity, enlarging and elaborating the glans into a complex, though still functionally undefined, copulatory structure. An enlarged glans putatively interacts with the female cloaca and may change the shape of her reproductive tract to facilitate insemination and increase the probability of fertilization. Here, we investigated the cellular-level properties of the glans and other inflatable phallic tissues associated with the sperm-conducting sulcus spermaticus in the American alligator (Alligator mississippiensis). Using histochemical staining, we visualized and defined collagen and elastin fiber densities and orientations in these tissues. Extracellular matrix architectures provided insights about phallic glans material properties and how they may affect tissue strength and flexibility during inflation and in response to copulatory forces. We also investigated the potential sources of fluids that induce inflation in alligator phalli. Combining serial sectioning and three-dimensional reconstruction, we identified a pair of supracrucal plexus vascular bodies at the proximal end of the alligator phallus that extend distally adjacent to ventro-medial sulcus tissues. Together, our gross and histological examination of the American alligator phallic glans suggests that its tissues are arranged in a manner that would allow vascular inflation to expand the glans to a specific and repeatable shape, and potentially release secretory products into the female reproductive tract. Both elements could play roles in postcopulatory sexual selection, by mechanically and/or chemically affecting female reproductive physiology.

During the fourth week of human embryo development, a transient common channel known as a cloaca is formed from which three cavities with three external orifices arises. Cloaca anomalies occur when there is failure of separation of the rectum, vagina, and urethra channel resulting in a single drain into the perineum. In our previous institutional studies, Runck et al. compared human and mouse cloaca development and found early mis-patterning of the embryonic cloaca deranged hedgehog and bone morphogenetic proteins (BMP) signaling. Also, our group reported the embryological correlation of the epithelial and stromal histology found in step sections of the common channel in 14 cloaca malformations in humans. In this review, we present the pathology of a 4-year-old female with a cloaca and VACTERL complex, and summarize our current knowledge of cloaca pathology. Furthermore, we suggest that careful pathological examination of cloaca specimens in conjunction with surgical orientation may result in a better understanding of the etiology of this condition.

In a 60-year-old woman, after extensive gangrene, the genitals represented next a picture: the large and small lips are absent, a small piece hangs from the left small lip. The defect resulting from gangrene is bordered by a scar, the remainder of the urinary bladder is directly adjacent to the rectal wall in the same place, where its integrity is broken.

Background: Cloaca is a common excretory channel for the genital, urinary, and gastrointestinal tracts. It is considered a severe anorectal malformation caused by failed partitioning of the genital, rectal, and urinary tracts. Methods: We report 5 infants with cloaca at birth who were identified prenatally by one or more of the following on prenatal ultrasound (US): ambiguous genitalia, a cystic pelvic/abdominal mass, hydronephrosis, ascites, a single umbilical artery, and oligohydramnios. Results: A cystic pelvic/abdominal mass and ambiguous genitalia were each observed in 3 cases by prenatal US. Ambiguous genitalia was observed in all 5 neonates at birth. There were 2 twin pregnancies (dichorionic/diamniotic and monochorionic/monoamniotic), with only 1 twin in a set affected with cloaca. Conclusion: Pediatricians should be alert to the prenatal US findings that may raise suspicion of a persistent cloaca to improve both prenatal counseling and family preparation.

Objective: Current study aimed for documenting a rare case in buffalo calves in Egypt about embryogenesis anomalies followed by dystocia. Material and methods: The stillborn calf was preserved using Elnady technique. The twin was radio-graphed in ventrodorsal position and several digital images were taken due to large size of the twin and were stitched together using Adobe Photoshop. The preserved twin specimen was kept in a wooden glass cabinet at the Anatomy Museum, Faculty of Veterinary Medicine, Cairo University with a booklet described the case and a video CD for dystocia operation steps in cows and buffalos. Results: The external features of the twin were classified as dicephalus, tetrabrachius, Parapagus, and bipus. Radiographic study showed that the twin had two vertebral columns that converged at the lumbosacral region to come adjacent to each other with absence of sacrum and coccygeal vertebrae. The trunk cavities showed two sets of heart and lung, two stomachs; left one in the abdominal cavity and the right one in thoracic cavity. The two duodenum fused together to form one set of intestine terminated in persistent cloaca with the two ureters originated from the single set of two kidneys. It had one fused liver received the two umbilical veins and had two gall bladders. Conclusion: The present study recommended the preservation of rare specimens using Elnady technique for long term to facilitate students interaction with one of the rarest cases in buffalo that causes dystocia. [J Adv Vet Anim Res 2020; 7(1.000): 56-61]

We describe a new sonographic sign for the detection of anal atresia in the early midtrimester on transvaginal sonography. In six cases of fetal anal atresia, the finding of a transient, distended, and right-sided sigmoid colon was observed at 13-16 weeks' gestation. Three cases have undergone pregnancy termination due to multiple anomalies. In the other three, the colonic distension resolved by 19 weeks' gestation. In two of these, the finding was isolated, and no other anomalies were detected. In all six cases, anal atresia or cloaca was confirmed on postabortal autopsy or after delivery. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:160-162, 2017.

Development of external genitalia and perineum is the subject of developmental biology as well as toxicology and teratology researches. Cloaca forms in the lower (caudal) end of endoderm. Such endodermal epithelia and surrounding mesenchyme interact with various signals to form the external genitalia. External genitalia (the anlage termed as genital tubercle: GT) formation shows prominent sexually dimorphic morphogenesis in late embryonic stages, which is an unexplored developmental research field because of many reasons. External genitalia develop adjacent to the cloaca which develops urethra and corporal bodies. Developmental regulators including growth factor signals are necessary for epithelia-mesenchyme interaction (EMI) in posterior embryos including the cloaca and urethra in the genitalia. In the case of male type urethra, formation of tubular urethra proceeds from the lower (ventral) side of external genitalia as a masculinization process in contrast to the case of female urethra. Mechanisms for its development are not elucidated yet due to the lack of suitable mutant mouse models. Because of the recent progresses of Cre (recombinase)-mediated conditional target gene modification analyses, many developmental regulatory genes become increasingly analyzed. Conditional gene knockout mouse approaches and tissue lineage approaches are expected to offer vital information for such sexually dimorphic developmental processes. This review aims to offer recent updates on the progresses of these emerging developmental processes for the research field of congenital anomalies.

Omphalocele, exstrophy of cloaca, imperforate anus, and spinal defect (OEIS) complex is an extremely rare congenital anomaly (1:2,00,000–1:4,00,000) comprising of OEIS. The associated anomalies pose multiple challenges during the anesthetic administration. We are reporting anesthetic management of a baby born with this rare syndrome, posted for an emergency surgery on the 1st day of life. Anesthetic management of a neonate with this complex and difficult airway in this relation has never been discussed previously.

The Wolffian duct develops from the intermediate mesoderm. Cells in the most rostral region undergo specification and migrate toward to the cloaca forming an epithelial tube. During migration, the epithelium induces the neighboring mesenchyme to form mesonephric tubules, which ultimately will form the efferent ducts. The expression of transcription factors is necessary for proper migration and tube formation. Multiple regulators are also expressed that are critical for Wolffian duct stabilization and morphogenesis. Failure to develop a fully functional epididymis of the correct length will result in male infertility.

Until the 12th week of gestation it is difficult to ascertain the sex of a human embryo based on the appearance of the external genitalia and yet the process is complete by 16–17 weeks. Our understanding of the complexity of the genetic and endocrinological interactions controlling this process continues to develop. There is emerging evidence that penile development has much in common with the development of limb buds. The developmental direction the indeterminate external genitalia take is driven by gonadal development which in turn is controlled by genetic sex determination. Though presented as sequential events, much of this happens in parallel. Between the 4th and 6th weeks the cloaca becomes divided into a posterior anorectal canal and an anterior urogenital sinus by the formation of the urorectal septum, the tip of which will eventually form the perineum. Simultaneously the mesoderm antero-lateral to the developing urogenital sinus expands to create the genital tubercle. When the cloacal membrane ruptures it exposes the floor of the urogenital sinus that will form the urethral plate. The mesoderm on either side of the urethral plate expands to form urogenital folds that extend into the genital tubercle. These are flanked by a pair of labioscrotal swellings. During the 6th week the urethral plate develops into a urethral groove which becomes the penile urethra as a result of fusion of the urogenital folds from proximal to distal, and is usually complete by 14 weeks. The formation of the glanular urethra is still under investigation and it is still unclear if it occurs by tubularization of the endoderm as in the penile urethra or through canalization of ectoderm distally. The prepuce itself develops as a result of ectodermal folding and cellular ingrowth resulting in the glans penis and inner prepuce sharing a common mucosal lining which gradually separates over years.

A healthy 14-year-old boy with a 3-month history of thigh pain and swelling is referred to a specialist centre with an uncertain diagnosis. After extensive tests and imaging a Brodie’s abscess is diagnosed. The abscess is complicated by a fistula (cloaca) through the cortical bone of the femur, resulting in a large complex soft tissue collection. This is a presentation, we are unaware has been documented in any literature. After specialist multi-team combined management (Paediatric Trauma and Orthopaedic and Paediatric Infectious Diseases), the patient undergoes two surgical procedures, and extensive antibiotic cover. The patient makes a good recovery with no long lasting sequelae to date.

The posterior cloaca (cloaca posterior) is the most rare type of cloacal anomaly representing one of the most complicated problems for the operative correction of the defect. A variety of options for the fusion of structures involved in the formation of urogenital sinus, vaginal and uterine anomalies cause the lack of a unified approach to surgical correction which would allow to obtain good anatomical and functional outcomes and a decent quality of life. The authors discuss a clinical case of successful treatment of a rare form of anorectal malformation - cloaca posterior in a 3-year old child.

In broiler breeder roosters, the weight of the testes is positively associated with daily sperm production and fertility. In birds, the testes are located in the coelomic cavity, not being accessible to reproductive evaluation as mammalian testes. The reproductive evaluation of roosters is based on phenotypic traits. Any changes on testes will be reflected on fertility levels. The aim of this paper was to evaluate the potential of association of phenotypic traits as body weight (BW), comb scores (COS), cloaca scores (CLS) and feet scores (FS) with testicular morphometric parameters in adult Cobb® Mx roosters in two ages (25 and 45 weeks of age). The low BW roosters had lower testes weight (TW), smaller seminiferous tubule diameter (STD) and lower comb and cloaca scores than the medium and high BW roosters (P≤0.05). Heavy roosters had the highest COS and bigger seminiferous epithelium height (SEH). There was no statistical difference between the BW categories in FS and volumetric proportion of seminiferous tubule (ST) and interstitial tissue (IT). Considering the age effect, roosters with 45 weeks of age had lower TW and ST than 25-week roosters. Positive, moderate and significant correlation was found between testes weight and phenotypic characteristics as BW, COS and CLS in 45week roosters. A positive, moderate and significant correlation was found between body weight and histologic testicular characteristics as STD and SHE in both evaluated ages. In conclusion, there is a regression in the testes weight with age and it is more intense in Cobb® Mx roosters with lower BW. Furthermore, it is concluded that the BW positively influences the testes weight and histological quality of the testes. COS and CLS can be used with moderate potential prediction to identify roosters with low testes weight at 45 weeks of age. RESUMO Em galos de matriz pesada sabe-se que o peso dos testículos pode ser associado positivamente com a produção diária de espermatozoides e que alterações nos testículos irão refletir na fertilidade. Nas aves, os testículos estão localizados dentro da cavidade celomática, e, portanto, não são acessíveis para exame andrológico direto, como em mamíferos. A avaliação reprodutiva de galos se baseia principalmente em características fenotípicas. Buscou-se avaliar o potencial de associação de alguns parâmetros fenotípicos, como peso corporal (PC), escores de crista (ECR), escores de cloaca (ECL) e escores de pés (EP), com parâmetros morfológicos de testículos em galos Cobb® Mx em duas idades (25 e 45 semanas de idade). Galos leves apresentaram menor peso testicular (PT), menor diâmetro de túbulo seminífero (DT), e menores ECR e ECL que galos médios e pesados (P≤0.05). Galos pesados apresentaram os maiores ECR e maiores valores para altura do epitélio seminífero (AE), e DT. Não houve diferença estatisticamente significativa entre as categorias de peso para escores de pé e proporções de túbulo seminífero (TS) e interstício (INT). Considerando-se o efeito da idade, galos com 45 semanas de idade apresentaram menores PT e TS que galos com 25 semanas de idade. Correlação positiva, moderada e significativa foi encontrada entre peso de testículo e características fenotípicas como ECR, ECL e PC em galos de 45 semanas de idade. Foi encontrada correlação positiva, moderada e significativa entre PC e características testiculares como DT e AE nas duas idades avaliadas. Conclui-se que em galos Cobb® Mx ocorre regressão do testículo com o avanço da idade, e ela é mais intensa em galos com menor peso corporal. Conclui-se que o PC tem influência positiva no peso e índices histomorfométricos dos testículos, e que escores de crista e de cloaca podem ser utilizados com potencial moderado de predição para identificar galos com baixo peso de testículos em galos com 45 semanas de idade.

Urachus or the median umbilical ligament is a fibrous strand connecting umbilicus to bladder, representing embryologic remnant of cloaca and allantois. Urachal anomalies are infrequent in adult population. Moreover they have a different course in adults than pediatric age group in which they are more common, frequently involute and have a benign course. These remnants are prone to infection and development of malignancy. A proper diagnostic workup by clinical and imaging tools is required. We present a case report of a urachal sinus complicated with abscess in an adult with brief review of the literature.

The structures of the female reproductive system (ovary, oviduct and cloaca) of Ichthyophis supachaii were investigated by dissection, histology and light microscopy. Paired, elongated, sac-like ovaries are parallel to the gut and fat bodies. Follicle stages include germinal nests of oogonia and primary oocytes, early and late previtellogenic follicles, early and late vitellogenic follicles and atretic follicles. Germinal nests of oogonia comprise oogonia and prefollicular cells. Nests of primary oocytes contain clusters of synchronously developing primary oocytes enclosed by connective tissue. Primary oocytes are associated with follicular cells. Previtellogenic follicles initially form the vitelline envelope, theca cell layers and patches of ooplasmic glycoproteins. Vitellogenic follicles contain heterogeneously sized spherical yolk granules. Atresia is present in several stages of developing follicles. The oviduct is divided into the anterior, middle and posterior parts. All oviductal parts are lined by non-ciliated epithelium. A small number of mucous cells are present in the middle part. The cloaca of female I. supachaii is divided into the anterior and posterior chambers. The anterior chamber is lined by glandular stratified columnar epithelium, while the posterior chamber has stratified cuboidal epithelium with less mucus production. Our results contribute to useful information on the reproductive biology of caecilians.

We describe an osseous metaplasia in a wild Patagonian green racer (Philodryas patagoniensis). The 5.5×1.5-cm lesion of irregular contour on the right dorsolateral surface proximal to the snake's cloaca was raised, hard, ulcerated centrally, and radiopaque and interfered with mobility. Microscopy revealed osseous metaplasia on skin and muscle.

Omphalocele, Exstrophy of cloaca, Imperforate anus and Spinal defects (OEIS) is a severe manifestation of exstrophy-epispadias sequence with a combination of defects including OEIS. It results from improper closure of anterior abdominal wall and defective development of cloaca and urogenital septum due to defect in blastogenesis during the 4th week of gestation. Identification of this complex is important through foetal autopsy as this condition can recur in siblings. Prenatal diagnosis also helps to prevent foetal death with appropriate management in the less severe cases. In severe cases, termination of pregnancy is considered. A primigravida with 28 weeks of gestation had delivered a live baby with multiple congenital anomalies; baby died after 10 minutes. These anomalies were grouped under OEIS complex.

The study includes six adult healthy hen turkey. The cloaca has three compartments separated by two circular folds and next to rectum is the coprodeum which the largest and measured (2.5±0.2cm) in length and (2.1±0.1cm) in diameter. The middle and smallest is the urodeum that measured about (1.01±0.2cm) in length and (1.2±1cm.) in diameter, that receives the ureter and left oviduct. Posteriorly, the proctodeum that measured about (1.4±0.1cm) in length and (1.6±1cm.) in diameter. The coprodeum mucosa has short and flat villi. The urodeum mucosa has tall branching pyramidal mucosal villi. The mucosa of proctodeum has lost the villi pattern. The three compartments were lined with mucous secreting columnar cells, most of these epithelial cells were positive for Alcian blue (2.5pH) stain and few were positive for PAS stain. The epithelial tubular glands showed positive reaction for Alcian blue satin only. The lamina propria of these compartments was cellular loose connective tissue displayed numerous of lymphatic nodules. The muscular mucosa is lost in proctodeum only. Tunica muscular is composed of two layers of smooth muscles fibers in coprodeum and urodeum and turned into skeletal type in proctodeum. The mean height of mucosal villi has significantly increased in urodeum.

Understanding normal human genital and urethral development is the first step in unraveling both rare and common congenital penile anomalies, and to draw a proper plan of reconstruction.

Genital malformation, including hypospadias, represents the second most common male birth defect after cardiac defect. In the past 50 years, hypospadias incidence has doubled along with other male reproductive problems. It is suspected that fetal exposure to endocrine disruptors may have contributed to this increase. However, our understanding of basic genitalia development in general, including hormone-mediated genital differentiation, is still very limited. A complete understanding of genetic pathways governing genital development and masculinization and how perturbations of these pathways lead to genital malformations will have important applications to improve global health. In the past 20 years, comprehensive genetic analyses on genital tubercle development in knockout and transgenic mice have revealed critical signaling pathways regulating both the initial genital outgrowth phase and the subsequent hormone-dependent genital masculinization phase. Interestingly, some signaling pathways, such as Wnt, Hh, and Fgf, are required during both phases of genital development. In this chapter, we will review genitalia development in mice as well as the effect of endocrine disruption on genitalia development. A thorough dissection of genetic pathways regulating posterior embryonic development should allow us to better understand gene–environment interactions that influence genitalia development and hypospadias formation.

The pronephros is the first kidney type to form in vertebrate embryos. The first step of pronephrogenesis in the zebrafish is the formation of the intermediate mesoderm during gastrulation, which occurs in response to secreted morphogens such as BMPs and Nodals. Patterning of the intermediate mesoderm into proximal and distal cell fates is induced by retinoic acid signaling with downstream transcription factors including wt1a, pax2a, pax8, hnf1b, sim1a, mecom, and irx3b. In the anterior intermediate mesoderm, progenitors of the glomerular blood filter migrate and fuse at the midline and recruit a blood supply. More posteriorly localized tubule progenitors undergo epithelialization and fuse with the cloaca. The Notch signaling pathway regulates the formation of multi-ciliated cells in the tubules and these cells help propel the filtrate to the cloaca. The lumenal sheer stress caused by flow down the tubule activates anterior collective migration of the proximal tubules and induces stretching and proliferation of the more distal segments. Ultimately these processes create a simple two-nephron kidney that is capable of reabsorbing and secreting solutes and expelling excess water—processes that are critical to the homeostasis of the body fluids. The zebrafish pronephric kidney provides a simple, yet powerful, model system to better understand the conserved molecular and cellular progresses that drive nephron formation, structure, and function.

The present study describes the development of excretory organ (kidney) in post flexion to fingerling stages of the Himalayan snowtrout Schizothorax plagiostomus (Heckel). In observation Schizothorax plagiostomus larvae having a pair of elongated kidney lies above the alimentary canal close to the vertebral column, which is divided into two parts i.e. head kidney and the trunk kidney. In post-flexion to fingerling larvae, the pronephric nephrons and tubules form immediately after the pronephric duct, which connect with the anterior most tips of pronephric duct. Pronephric tubules were convoluted in anterior side and there is a small amount of erythroid and lymphoid tissue associated with this region. At the same time caudal portion of the pronephric duct (near cloaca) starts to become broad in comparison to other parts in 2.0-4.0 cm larvae. On fingerling stage obvious tubules were found in kidney with large blast like cells (Columnar epithelial cells) between the nephric tubules.

Within amniotes, external copulatory organs have undergone extensive morphological diversification. One of the most extreme examples is squamate (lizards and snakes) hemipenes, which are paired copulatory organs that extend from the lateral margins of the cloaca. Here, we describe the development of hemipenes in a basal snake, the ball python (Python regius). Snake hemipenes arise as a pair of lateral swellings on either side of the caudal part of the cloaca, and these paired outgrowths persist to form the left and right hemipenes. In non-squamate amniotes, external genitalia form from paired swellings that arise on the anterior side of the cloaca, which then fuse medially to form a single genital tubercle, the anlagen of the penis or clitoris. Whereas in non-squamate amniotes, Sonic hedgehog (Shh)-expressing cells of the cloacal endoderm form the urethral or sulcus epithelium and are required for phallus outgrowth, the hemipenes of squamates lack an endodermal contribution, and the sulcus does not express Shh. Thus, snake hemipenes differ from the genital tubercles of non-squamate amniotes both in their embryonic origins and in at least part of patterning mechanisms, which raises the possibility that hemipenes may not be direct homologs of the unpaired amniote penis. Nonetheless, we find that some developmental genes show similar expression patterns in snake hemipenes buds and non-squamate genital tubercles, suggesting that homologous developmental mechanisms are involved in aspects of external genital development across amniotes, even when these structures may have different developmental origins and may have arisen independently during evolution.

In mammalian urorectal development, the urorectal septum (urs) descends from the ventral body wall to the cloaca membrane (cm) to partition the cloaca into urogenital sinus and rectum. Defective urs growth results in human congenital anorectal malformations (ARMs), and their pathogenic mechanisms are unclear. Recent studies only focused on the importance of urs mesenchyme proliferation, which is induced by endoderm-derived Sonic Hedgehog (Shh). Here, we showed that the programmed cell death of the apical urs and proximal cm endoderm is particularly crucial for the growth of urs during septation. The apoptotic endoderm was closely associated with the tempo-spatial expression of Wnt inhibitory factor 1 (Wif1), which is an inhibitor of Wnt-β-catenin signaling. In Wif1(lacZ/lacZ) mutant mice and cultured urorectum with exogenous Wif1, cloaca septation was defective with undescended urs and hypospadias-like phenotypes, and such septation defects were also observed in Shh(-/-) mutants and in endodermal β-catenin gain-of-function (GOF) mutants. In addition, Wif1 and Shh were expressed in a complementary manner in the cloaca endoderm, and Wif1 was ectopically expressed in the urs and cm associated with excessive endodermal apoptosis and septation defects in Shh(-/-) mutants. Furthermore, apoptotic cells were markedly reduced in the endodermal β-catenin GOF mutant embryos, which counteracted the inhibitory effects of Wif1. Taken altogether, these data suggest that regulated expression of Wif1 is critical for the growth of the urs during cloaca septation. Hence, Wif1 governs cell apoptosis of urs endoderm by repressing β-catenin signal, which may facilitate the protrusion of the underlying proliferating mesenchymal cells towards the cm for cloaca septation. Dysregulation of this endodermal Shh-Wif1-β-catenin signaling axis contributes to ARM pathogenesis.

Objective Describe a case of cloaca prenatally diagnosed in one of a set of monoamniotic twins. Study Design Retrospective review of a case. Results Cloaca is one of the most complex and severe degrees of anorectal malformations in girls. We present a discordant cloaca in monoamniotic twins. Fetal ultrasound showed a female fetus with a pelvic midline cystic mass, a phallus-like structure, a probable anorectal atresia with absence of anal dimple and a flat perineum, and renal anomalies. The diagnosis was confirmed by fetal magnetic resonance imaging postnatally. Conclusions The rarity of the malformation in a monoamniotic pregnancy, the difficulties of prenatal diagnosis, the pathogenic assumptions, and the consequences of adequate amniotic fluid for fetal lung development are discussed.

Computer tomography of kidneys, ureters and bladder (CT KUB) is the main investigation in suspected renal tract calculi. Ultrasound of kidneys, ureters and bladder (KUB) region can come in hand during acute conditions especially in patients with ureteric calculus causing hydronephrosis and hydroureter. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe series of cases who presented with renal colic. CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder wall calcification, confirmed by reviewing the multi- planar reformatted images. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification. Our study shows urachus calcification is much more common in patients than previously taught and more common in older patients of more than 50 years than younger patients. INTRODUCTION: The urachus or median umbilical ligament is a midline tubular structure that extends upward from the anterior dome of the bladder toward the umbilicus. It is a vestigial remnant of at least two embryonic structures: the cloaca, which is the cephalic extension of the urogenital sinus (a precursor of the fetal bladder), and the allantois, which is a derivative of the yolk sac 1, 2 . The tubular urachus normally involutes before birth, remaining as a fibrous band with no known function. However, persistence of an embryonic urachal remnant can give rise to various clinical problems, not only in infants and children but also in adults. Because urachal remnant diseases are uncommon and manifest with nonspecific abdominal or urinary signs and symptoms, definitive presurgical diagnosis is not easily made. Various abnormalities can be confusing unless one is familiar with the basic embryologic anatomy and imaging features of the subumbilical and prevesical region. Because computed tomography (CT) and ultrasonography (US) display cross- sectional images and the urachus in the anterior abdominal wall is located away from interfering intestinal structures, these modalities are ideally suited for demonstrating urachal anomalies 2-6 . Calcification of urachal remnant is very rare entity and we present a series of cases in this article.

OEIS is an extremely rare constellation of malformations, which includes omphalocele, exstrophy of cloaca, imperforate anus, and spinal defect. We report here autopsy findings in a case of OEIS complex, which apart from the major anomalies of the complex had bilateral club foot that is, congenital talipes equinovarus, right hydroureter, and body stalk anomaly. The umbilical cord was absent, and the umbilical vessels were embedded in an amniotic sheet, which connected the skin margin of the anterior body wall defect to the placenta, this feature being the hallmark of limb body wall complex (LBWC). This case further supports the view that OEIS and LBWC represent a continuous spectrum of abnormalities rather than separate conditions and may share a common etiology and pathogenetic mechanism as proposed by some authors.

Colorectal pediatric surgery is a diverse field that encompasses many different procedures. The pullthrough for Hirschsprung disease, the posterior sagittal anorectoplasty for anorectal malformations including complex cloaca reconstructions and the ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis present some of the most technically challenging procedures pediatric surgeons undertake. Many children prevail successfully following these surgical interventions, however, a small number of patients suffer from complications following these procedures. Anticipated postoperative problems are discussed along with medical and surgical strategies for managing these complications.

The nephron is the functional unit of the kidney and is divided into distinct proximal and distal segments. The factors determining nephron segment size are not fully understood. In zebrafish, the embryonic kidney has long been thought to differentiate in situ into two proximal tubule segments and two distal tubule segments (distal early; DE, and distal late; DL) with little involvement of cell movement. Here, we overturn this notion by performing lineage-labelling experiments that reveal extensive caudal movement of the proximal and DE segments and a concomitant compaction of the DL segment as it fuses with the cloaca. Laser-mediated severing of the tubule, such that the DE and DL are disconnected or that the DL and cloaca do not fuse, results in a reduction in tubule cell proliferation and significantly shortens the DE segment while the caudal movement of the DL is unaffected. These results suggest that the DL mechanically pulls the more proximal segments, thereby driving both their caudal extension and their proliferation. Together, these data provide new insights into early nephron morphogenesis and demonstrate the importance of cell movement and proliferation in determining initial nephron segment size.

The OEIS complex comprises of a combination of defects including Omphalocele, Exstrophy of the cloaca, Imperforate anus and Spinal defects. It represents the most severe manifestation of EES (exstrophy epispadias sequence). It results from defective blastogenesis in 4th week of gestation, resulting in improper closure of anterior abdominal wall and defective development of cloaca and urogenital septum. A third gravida with previous normal obstetric history was diagnosed by prenatal ultrasound to have a grossly malformed fetus. It was provisionally diagnosed as OEIS complex by nonvisualisation of bladder, presence of omplalocele, limb and spinal defects in the ultrasound.Hysterotomy confirmed the defects in the dead baby, which was further confirmed by autopsy, fetal CT scan and X-ray. Prognosis depends on severity of bladder exstrophy and neural tube defects. Likewise, management varies from interruption of pregnancy in severe cases to appropriate perinatal management in less severe cases by team of obstetricians, neonatologists, pediatric surgeons and neurosurgeons.

We describe a case of OEIS complex [Omphalocele-Exstrophy of the Bladder-anal imperforation-spina bifida] a rare congenital malformation complex. It results from improper closure of ventral abdominal wall due to failure of convergence of cephalo-caudal and lateral foldings of embryo during development, with asociated defects in development of cloaca and urorectal septum. A second gravida, with previous normal obstetric history of 35 wks of gestation spontaneously delivered a live pre term baby with gross malformations of a large omphalocele containing kidney,liver and intestines, bladder exstrophy, anal imperforation and spina bifida. Patients with OEIS complex require the care of a multidisciplinary team with multiple surgeries with its own potential complications. Hence, early antenatal diagnosis and evaluation provides prognostic information, treatment options, decisions concerning the management and the plan for specific needs at birth.

Embryonic remnant of the cloaca and the allantois present after birth as a midline fibrous cord is usually detected in infancy and childhood. Failure to obliterate results in urachal disease is rare in adults. Varied remnants of the urachus have been reported. In this case report the usefulness of basic high resolution sonography for initial screening & usefulness of MRI in delineating the length of tract in an adult has been highlighted.DOI: http://dx.doi.org/10.3126/njr.v4i1.11371 Nepalese Journal of Radiology, Vol.4(1) 2014: 56-58

OEIS complex is a rare and complex anomaly of the genitourinary and intestinal tract. It includes Omphalocele, Exstrophy of cloaca, Imperforate anus and Spinal defects. Cloacal exstrophy is considered the most severe ventral abdominal wall defect. The defect occurs due to failure of convergence of mesodermal migrations and inability of development of urorectal septum during embryonic life. The failure of these two events to occur manifests as exstrophy of bladder and bowel. Diagnosis is primarily based on the presenting features. Management requires initial resuscitation and stabilization followed by either single staged closure or multistage procedures by multi-disciplinary surgical team. We are reporting a case of classical case of OEIS complex managed successfully at our center.

Urorectal septum malformation sequence is a sporadic malformation due to failure of septation of primitive cloaca with no anal opening. Umbilical cyst can be associated with chromosomal aneuploidy such as trisomy 18 or trisomy 13. We report on a fetus with complete urorectal septum malformation sequence with an umbilical cyst resulting from a patent urachus and with meconium as its content. This report adds to the variety of the causes of umbilical cyst and the spectrum of consequences of urorectal septal defect.

Study on the morphology of external organs of the body of peroryctids is less available. Bandicoot (Echymipera kalubu) is one of marsupial in peroryctids and is endemic species in Papua. The morphological characteristic of the external organs of five adults bandicootS (E. kalubu) with the body weight of 1,16 ± 0,29 kg and 38,2 ± 4,76 cm of body length were studied macroscopically. The external organs of the body of bandicoot were identified the eye, nose, limb and reproductive systems. The nose of the E. kalubu had tactile hairs on the trunk and the cheek under the eye. The ear of the E. kalubu had tragus. The forelimb which were shorter of the hind limb. The hind limb unique where only consisting of four toes and having five claws. The tail of the E. kalubu there was long but there were also species are not having tail. Uniqueness was also in the external organs of reproductive systems which there is only scortum, that out the abdomen of the body. The penis not found around skortum. The condition reproductive system of male E. kalubu like cloaca in poultry. The penis only will look when there was coitus. In a female has sac with the nipple.

This study aimed to evaluate the safety and efficacy of single-incision laparoscopic-assisted anorectoplasty (SILAARP) for children with persistent cloaca.Five patients with persistent cloaca underwent SILAARP and repair of the urogenital sinus between June 2014 and February 2015. The mean age of the patients at the time of operation was 0.80 ± 0.16 year (range, 0.6-1.0 year). An extralong 5-mm 30° laparoscope was inserted through the 5-mm middle port. Two 3-mm lateral ports were placed for instruments. The three ports were placed at a horizontal line through a 2-cm transumbilical incision. CO2 pressure was maintained between 8 and 12 mm Hg. The patients were evaluated for fecal continence and complications.SILAARP and repair of the urogenital sinus were successfully performed in all patients. The mean operation time ranged from 120 minutes to 130 minutes. The operative blood loss was minimal. There were no operative complications. All patients were followed up for 0.64 ± 0.29 year (range, 0.3-1.0 year). No patient developed fecal incontinence. Two of the 5 patients (40%) had two to four stools per days, but this did not cause social problems. Only 1 patient (20%) had constipation and required changes in diet. No wound infection, port-site hernia, urethrovaginal fistula, acquired anorectal atresia, or urethral injury occurred.Our results show that SILAARP is an effective and safe option for patients with persistent cloaca.

When a female is born and has only a single perineal orifice on the newborn clinical examination, a diagnosis of cloaca type of anorectal malformation is made. Along with associated malformations which may initiate the ordering of radiologic imaging, there are a finite number of radiologic tests that are performed to help in the immediate management of the patient with cloaca. The following discussion will outline the most important radiologic tests and demonstrate examples of images from newborn females with cloaca.