Cloacal exstrophy

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Cloacal exstrophy
Other names Omphalocele-cloacal exstrophy-imperforate anus-spinal defect syndrome
Specialty Medical genetics   OOjs UI icon edit-ltr-progressive.svg
Complications Limb deformities, open neural tube defects [1]
TreatmentSurgical intervention

Cloacal exstrophy (EC) is a severe birth defect wherein much of the abdominal organs (the bladder and intestines) are exposed. It often causes the splitting of the bladder, genitalia, and the anus. It is sometimes called OEIS complex. [2]

Contents

Diagnostic tests can include ultrasound, voiding cystourethrogram (VCUG), intravenous pyelogram (IVP), nuclear renogram, computerized axial tomography (CT scan), and magnetic resonance imaging (MRI). [3] Cloacal exstrophy is a rare birth defect, present in 1/200,000 pregnancies and 1/400,000 live births. It is associated with a defect of the ventral body wall and can be caused by inhibited mesodermal migration. [4] The defect can often be comorbid with spinal bifida and kidney abnormalities. [5] Many individuals who are born with XY cloacal exstrophy are assigned female at birth due to the appearance of the external genitalia. [6] [7] Performing genital surgery on intersex infants for cosmetic purposes is considered a human rights violation by the World Health Organization. [8] [9]

See also

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Abdominal wall defects are a type of congenital defect that allows the stomach, the intestines, or other organs to protrude through an unusual opening that forms on the abdomen.

The development of the digestive system in the human embryo concerns the epithelium of the digestive system and the parenchyma of its derivatives, which originate from the endoderm. Connective tissue, muscular components, and peritoneal components originate in the mesoderm. Different regions of the gut tube such as the esophagus, stomach, duodenum, etc. are specified by a retinoic acid gradient that causes transcription factors unique to each region to be expressed. Differentiation of the gut and its derivatives depends upon reciprocal interactions between the gut endoderm and its surrounding mesoderm. Hox genes in the mesoderm are induced by a Hedgehog signaling pathway secreted by gut endoderm and regulate the craniocaudal organization of the gut and its derivatives. The gut system extends from the oropharyngeal membrane to the cloacal membrane and is divided into the foregut, midgut, and hindgut.

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References

  1. Ben‐Neriah, Z.; Withers, S.; Thomas, M.; Toi, A.; Chong, K.; Pai, A.; Velscher, L.; Vero, S.; Keating, S.; Taylor, G; and Chitayat, D. (2007)." OEIS complex: prenatal ultrasound and autopsy findings". Ultrasound Obstet Gynecol, 29: 170-177. https://doi.org/10.1002/uog.3874
  2. "OMIM Entry - 258040 - OEIS COMPLEX". omim.org. Retrieved 2018-01-29.
  3. "G/U Imaging:Home". www.meddean.luc.edu. Retrieved 2018-01-29.
  4. Hassan, Moaied A. (May 2018). "OEIS complex with a vesico-enteric fistula". Journal of Pediatric Surgery Case Reports. 35: 45–47. doi: 10.1016/j.epsc.2018.05.016 .
  5. "Omphalocele, exstrophy of the cloaca, imperforate anus, and spinal defects complex". Genetic and Rare Diseases Information Center. US Department of Health & Human Services. Archived from the original on 2021-01-16. Retrieved 2021-01-14. There is a high association with other birth defects, especially spina bifida, which occurs in up to 75% of cases. Omphalocele, a defect of the abdominal wall in the region of the umbilicus, is also common, as are kidney abnormalities.
  6. Myers, C.; Lee, P.A. (March 1, 2004). "Communicating with Parents with Full Disclosure: A Case of Cloacal Extrophy with Genital Ambiguity". Journal of Pediatric Endocrinology and Metabolism. 17 (3): 273–280. doi:10.1515/JPEM.2004.17.3.273. S2CID   23729036 via www.degruyter.com.
  7. Alice D. Dreger; April M. Herndon. "Progress and Politics in the intersex rights movement, Feminist theory in action" (PDF).
  8. Carpenter, Morgan (December 2018). "Intersex Variations, Human Rights, and the International Classification of Diseases". Health and Human Rights. 20 (2): 205–214. PMC   6293350 . PMID   30568414.
  9. Greenberg, Julie A. (June 2017). "Legal, ethical, and human rights considerations for physicians treating children with atypical or ambiguous genitalia". Seminars in Perinatology. 41 (4): 252–255. doi:10.1053/j.semperi.2017.03.012. PMID   28478089.