Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2025; 13(24): 107233
Published online Aug 26, 2025. doi: 10.12998/wjcc.v13.i24.107233
Iatrogenic cloaca: A case report
Laveena Balani, Ashok Kumar
Laveena Balani, Ashok Kumar, Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Co-first authors: Laveena Balani and Ashok Kumar.
Author contributions: Kumar A designed the concept, revised and edited the manuscript; Balani L did the literature search and wrote the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ashok Kumar, FACS, FASCRS, FRCS, FRCS (Ed), Full Professor, Professor, Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, Uttar Pradesh, India. doc.ashokgupta@gmail.com
Received: March 19, 2025
Revised: April 19, 2025
Accepted: May 13, 2025
Published online: August 26, 2025
Processing time: 89 Days and 19 Hours
Abstract
BACKGROUND

Traumatic cloacal deformities are a result of major obstetric injury and usually happens after a fourth-degree perineal laceration. This is characterized by complete disruption of the perineal body, anterior defect of the internal and external anal sphincter, and loss of the distal rectovaginal and/or anovaginal septum. The common chamber incorporating vagina and recto anal outlet ensues as cloaca.

CASE SUMMARY

We present a case of unmarried 15-year female, who developed hematometra and was diagnosed as cervical ostia obstruction at the age of 12 year. She underwent drainage of hematometra, and later some abdominal and perineal procedures elsewhere and subsequently developed fecal discharge from the vagina. Examination revealed absence of posterior wall of vagina and anterior wall of anorectum. In addition, the anterior half of the anal sphincter was also absent. She underwent vaginoplasty, anorectoplasty, sphincteroplasty with levatorplasty with creation of rectovaginal septum.

CONCLUSION

This case report highlights expert management of a case of mismanaged benign gynaecological condition in a young female that resulted in lifelong impairment of the patient's quality of life following hysterectomy and salpingo-oophorectomy, leading to the development of a common cloaca.

Keywords: Iatrogenic cloaca; Hematocolpometra mismanagement; Reconstruction; Sphincteroplasty; Vaginoplasty; Complications; Case report

Core Tip: This rare and unusual case highlights the mismanagement of hematocolpometra in a child and its subsequent complication in the form of iatrogenic cloaca. Here the authors discuss the management of this patients in details, and review the literature on surgical management of iatrogenic cloaca.