1. Drawings of the preferred operative procedure, single or multiple stages. A. The ileocecal plate is closed demonstrating preservation of the appendix, and the pubic rami have been reapproximated. B. Lateral illustration of the end-colostomy with appendix, stents in the ureters, and the Foley catheter exiting a reconstructured urethra. The ureteral stents more often would exit the bladder, along with a suprapubic tube, if the anterior surface of the bladder is completely closed. Stents may also exit on the abdominal wall if the anterior surface of the bladder cannot be closed. C. The common end result of the first stage of a closure with the hemibladders reapproximated in the posterior midline and the bladder mucosa exposed on the lower abdominal wall. A urethral reconstruction will be deferred, the appendix is still attached to the cecum, and the end colostomy exits the left upper quadrant. D. The end colostomy in the left upper quadrant. The appendix has now been used to create an appendicovesicostomy for the intermittent catheterization of the bladder.
Source: Cloacal Exstrophy, Operative Pediatric Surgery
Citation: Ziegler MM, Azizkhan RG, Allmen D, Weber TR. Operative Pediatric Surgery; 2014 Available at: Accessed: October 30, 2017
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