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Iatrogenic cloaca: A case report.

Laveena Balani¹, Ashok Kumar²

¹Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India.

World Journal of Clinical Cases

|August 27, 2025

Summary

This summary is machine-generated.

A rare case of a 15-year-old female with a cloacal deformity resulting from a mismanaged gynecological condition is presented. Surgical reconstruction was performed to address the severe anatomical defects and improve quality of life.

Keywords:

Case report Complications Hematocolpometra mismanagement Iatrogenic cloaca Reconstruction Sphincteroplasty Vaginoplasty

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Area of Science:

Gynecology
Surgical Reconstruction
Anorectal Surgery

Background:

Traumatic cloacal deformities arise from severe obstetric injuries, typically fourth-degree perineal lacerations.
Characterized by disruption of the perineal body, anal sphincters, and rectovaginal septum, leading to a common cloacal chamber.

Observation:

A 15-year-old female presented with a history of hematometra due to cervical ostia obstruction, followed by fecal vaginal discharge after prior procedures.
Examination revealed absence of the posterior vaginal wall, anterior anorectal wall, and anterior anal sphincter.

Findings:

The patient underwent complex reconstructive surgery including vaginoplasty, anorectoplasty, sphincteroplasty, and levatorplasty.
Surgical creation of a rectovaginal septum was a key component of the reconstruction.

Implications:

This case underscores the critical importance of expert management in benign gynecological conditions to prevent lifelong impairment.
Highlights the potential for severe functional deficits and quality of life reduction following mismanaged conditions and subsequent hysterectomy/salpingo-oophorectomy.