Talk:Cloaca Development

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Cite this page: Hill, M.A. (2024, March 29) Embryology Cloaca Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Cloaca_Development

2018

The development of the cloaca in the human embryo

J Anat. 2018 Dec;233(6):724-739. doi: 10.1111/joa.12882. Epub 2018 Oct 7.

Kruepunga N1,2, Hikspoors JPJM1, Mekonen HK1, Mommen GMC1, Meemon K2, Weerachatyanukul W2, Asuvapongpatana S2, Eleonore Köhler S1, Lamers WH1,3.

Abstract

Subdivision of cloaca into urogenital and anorectal passages has remained controversial because of disagreements about the identity and role of the septum developing between both passages. This study aimed to clarify the development of the cloaca using a quantitative 3D morphological approach in human embryos of 4-10 post-fertilisation weeks. Embryos were visualised with Amira 3D-reconstruction and Cinema 4D-remodelling software. Distances between landmarks were computed with Amira3D software. Our main finding was a pronounced difference in growth between rapidly expanding central and ventral parts, and slowly or non-growing cranial and dorsal parts. The entrance of the Wolffian duct into the cloaca proved a stable landmark that remained linked to the position of vertebra S3. Suppressed growth in the cranial cloaca resulted in an apparent craniodorsal migration of the entrance of the Wolffian duct, while suppressed growth in the dorsal cloaca changed the entrance of the hindgut from cranial to dorsal on the cloaca. Transformation of this 'end-to-end' into an 'end-to-side' junction produced temporary 'lateral (Rathke's) folds'. The persistent difference in dorsoventral growth straightened the embryonic caudal body axis and concomitantly extended the frontally oriented 'urorectal (Tourneux's) septum' caudally between the ventral urogenital and dorsal anorectal parts of the cloaca. The dorsoventral growth difference also divided the cloacal membrane into a well-developed ventral urethral plate and a thin dorsal cloacal membrane proper, which ruptured at 6.5 weeks. The expansion of the pericloacal mesenchyme followed the dorsoventral growth difference and produced the genital tubercle. Dysregulation of dorsal cloacal development is probably an important cause of anorectal malformations: too little regressive development may result in anorectal agenesis, and too much regression in stenosis or atresia of the remaining part of the dorsal cloaca. KEYWORDS: 3D morphometry; anorectum; bladder; urogenital sinus; urorectal septum

Congenital prepubic sinus-An aborted dorsal urethral duplication or a cloacal remnant?

J Pediatr Surg. 2018 Jul 25. pii: S0022-3468(18)30451-2. doi: 10.1016/j.jpedsurg.2018.07.014. [Epub ahead of print]

Nazir Z1, Khan MAM2, Qamar J2.

Abstract BACKGROUND: Congenital Prepubic Sinus (CPS) is an uncommon urogenital anomaly characterized by a blind tract between the skin over the pubis to anterior of the urinary bladder, Urethra or umbilicus. We report four such cases to emphasize varied clinical presentation and embryological conundrum. METHODS: Following Ethical Review Committee (ERC) approval, medical records of pediatric patients (<16 years) presenting with CPS (identified through operating room records and Hospital Information Management System (HIMS) between 1994 and 2018 were reviewed for demographics, clinical presentation, investigations including histopathology, management and outcome. RESULTS: Four cases of CPS, 3 females and 1 male, age range 9 months to 13 years were managed over 25-years. Clinical presentation includes a discharging sinus and recurrent episodes of cellulitis and abscess formation in pubic area and labia majora. Urological investigations were mostly normal. Insertion of lacrimal probe or plastic sheath of intravenous cannula through the sinus opening was useful to determine the course of sinus and aid its excision. Histology of excised sinus highlights the possible embryological origin. CONCLUSIONS: CPS is a rare anomaly with varied clinical presentation. It seems CPS is an aborted urethral duplication (Stephen Type 3) or a Cloacal remnant. Complete excision of the tract in the reported cases was curative. TYPE OF STUDY: Case series. LEVEL OF EVIDENCE: IV. Copyright © 2018 Elsevier Inc. All rights reserved. KEYWORDS: Cloacal membrane; Congenital; Congenital prepubic sinus; Duplication of urethra; Infants and children; Sinus PMID: 30115449 DOI: 10.1016/j.jpedsurg.2018.07.014


Historic

Imlach F. Case of cloaca in a child. (1875) Trans Edinb Obstet Soc. 3:66-68. PMID 29613532