Iatrogenic cloaca: A case report.

BACKGROUND

Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration. This is characterized by complete disruption of the perineal body, anterior defect of the internal and external anal sphincter, and loss of the distal rectovaginal and/or anovaginal septum. The common chamber incorporating vagina and recto anal outlet ensues as cloaca.

CASE SUMMARY: We present a case of unmarried 15-year female, who developed hematometra and was diagnosed as cervical ostia obstruction at the age of 12 year. She underwent drainage of hematometra, and later some abdominal and perineal procedures elsewhere and subsequently developed fecal discharge from the vagina. Examination revealed absence of posterior wall of vagina and anterior wall of anorectum. In addition, the anterior half of the anal sphincter was also absent. She underwent vaginoplasty, anorectoplasty, sphincteroplasty with levatorplasty with creation of rectovaginal septum.

CONCLUSION

This case report highlights expert management of a case of mismanaged benign gynaecological condition in a young female that resulted in lifelong impairment of the patient's quality of life following hysterectomy and salpingo-oophorectomy, leading to the development of a common cloaca.