The cloacal malformation: radiologic findings and imaging recommendations

Article Abstract:

Cloacal malformation is an abnormality found in one of every 40,000 to 50,000 newborn females. It occurs when the cloaca, a common canal for urine, genital secretions and feces, remains present throughout the development of the fetus. Normal development results in a different outlet for each system, but this abnormality leads to only one, common opening. This can result in severe complications, particularly involving the kidneys. Early surgical repair can usually provide close to normal functioning and prevent complications, but effective treatment requires accurate imaging of the malformations and of the affected areas in the kidneys. In this study, the imaging results and medical records from 65 infants born with cloacal malformation were reviewed. Included were clinical, imaging, cystoscopic, and surgical data. The information was examined to learn the characteristics of cloacal malformation and its associated complications, and to find ways to improve diagnosis and treatment using imaging techniques. Results showed that X-rays of the malformation could classify its configuration into two groups, either urethral or vaginal. The connection between the bladder and the cloaca was found to be of three different types (by way of the urethra or vesical or by direct connection). Rectal communication was either vaginal, cloacal, or other. A large percentage of the patients had abnormalities of the pelvic structures. These included an accessory urethra, protrusions (diverticula) of the bladder, and duplication of the uterus. Many other abnormalities were found in the urinary and genital tracts, the lower spinal cord, and the kidneys. Both MR imaging and sonography (ultrasound) were of limited value in characterizing and imaging these structures for diagnosis and treatment. Imaging using a contrast agent and fluoroscopic monitoring was the diagnostic tool of greatest value. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Abnormalities, Birth defects, Contrast media, Contrast media (Chemicals), Genitourinary organs, Fluoroscopy, Urogenital abnormalities

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Bronchopulmonary dysplasia: radiographic appearance in middle childhood

Article Abstract:

Bronchopulmonary dysplasia (BPD) is abnormal tissue development (dysplasia) in the two main airways (bronchi) of the lungs. BPD occurs primarily in premature infants. As infants with BPD mature they do not show improvement in pulmonary (lung) function during the middle and later years of childhood. Chest X-ray (radiograph) images among BPD survivors were studied. Because most infants with BPD do not reach childhood, experience with patients in middle childhood (eight to nine years of age) is infrequent. X-ray images of children suffering from BPD in middle childhood revealed lung abnormalities consisting of matter (e.g., bacteria, protozoa) in spaces of the lung (interstitial spaces), and chronic atelectasis (condition in which lungs remain partially or totally unexpanded, originating during fetal development). Fibrous lung tissue was frequently found in survivors of BPD. In cases where prenatal BPD was not complicated by respiratory distress syndrome (severe impairment of respiratory function in the premature newborn) the data show that the lungs in the middle childhood survivors are seldom abnormal on X-ray images. In general, however, most middle childhood survivors of BPD demonstrate abnormal X-ray images.

Causes of, Lungs, Lung, Lung diseases, Bronchopulmonary dysplasia, Atelectasis

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Apparent association between thymic cysts and prior thoracotomy

Article Abstract:

Most thymic cysts are congenital, inflammatory or neoplastic. Some are caused by trauma to the thymus while radiation therapy has caused others. The three thymic cysts discussed in this report developed postoperatively. They are the only ones of this type yet to be reported. Two cases were shown by computed tomography and radiography, while the third was discovered during cardiac surgery. These three patients and three discussed in an earlier paper suggest that a causal factor for thymic cysts may be trauma during surgery. The three patients reported on and the three earlier patients were all male but it is unclear whether this is a male-related pathologic process or a matter of chance.

Medical examination, Surgery, Thymus, Thymus gland, Cysts, Chest, Mediastinum, Thoracic surgery

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