PMC6298283_01
The central area of defect was identified as caecal plate "C" with a dilated prolapsed terminal ileum "I" with the length of 4-5 cm presenting as characteristic "elephant trunk deformity." A small sized opening on the prolapsed terminal ileum which noted to be passing meconium (arrow). On lateral aspects, there were exstrophy bladder plates with two hemispheric bladders "H" each of which contains a visible ureteric orifice "*". Genital anomalies with asymmetrical widely bifid sacro labial folds that were hyperpigmented. The gonad was palpable in the left side with absent phallus.
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F1
The gonad was palpable in the left side only with absent phallus and absent urethral opening [Figure 1].
Computed tomography image showing widening of symphysis pubis indicating an open book pelvic deformity with bilateral congenital hip dislocation, mildly balanced congenital scoliosis, multilevel vertebral failure of formation and segmentation with hemivertebra seen at the midthoracic and lumbosacral regions, and posterior spinal dysraphism at the lower lumbosacral region, associated with low-lying spinal cord that herniates dorsally representing myelomeningocele.
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F2
A posterior spinal dysraphism at the lower lumbosacral region was noted that was associated with a low-lying spinal cord that herniates dorsally with skin coverage representing a tethered cord with myelomeningocele [Figure 2].