Cloacal Exstrophy

The cloacal membrane normally ruptures leaving only the urogenital sinus (the urethra and vaginal introitus) and the rectum patent. If mesoderm (which will become the abdominal muscles) has not separated the ectoderm from the endoderm between the alantois and the genital tubercle, exstrophy occurs. If rupture of the cloacal membrane occurs before the uro-rectal septum has separated the bladder from the hind gut, the urethra, bladder and large bowel lie open as plates of mucosa on the lower abdomen.


See movie of cloacal exstrophy.


This infant has cloacal exstrophy. Notice that the bladder is actually two patches of mucosa, each with its own ureteric orifice, lying on either side of a patch of large bowel.


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©David A. Hatch, M.D., 1996