Imaging: Radiology management to assess for associated VACTERL defects: — Spine and sacrum – AP and lateral spine radiography including AP and lateral sacrum, spinal US for tethered cord, pelvic MRI if sacral mass detected (to look for sacral teratoma or anterior meningocele) — Congenital heart disease – Echocardiogram — Esophageal atresia – Nasogastric tube placement then CXR and AXR — Genitourinary – Renal and bladder US — Limb radiographs as clinically indicated — In female with cloaca get renal and pelvis US to look for hydrocolpos — Assess for recto-urethral fistula prior to repair with distal colostogram — Assess cloaca prior to repair with 3D cloacagram
DDX:
Complications:
Treatment:
Clinical:
Radiology Cases of VACTERL Association
Radiology Cases of VACTERL Association and Radial Ray Hypoplasia
Radiology Cases of VACTERL Association and Renal Agenesis
AP radiograph of the spine (left) shows multiple segmentation anomalies in the sacrum. Sagittal US of the left kidney (above right) is unremarkable while sagittal US of the right renal fossa (below right) shows a prominent right adrenal gland and absence of the right kidney.
Radiology Cases of VACTERL Association and Vertebral Body Anomalies
AP radiograph of the spine (left) shows multiple segmentation anomalies in the sacrum. Sagittal US of the left kidney (above right) is unremarkable while sagittal US of the right renal fossa (below right) shows a prominent right adrenal gland and absence of the right kidney.CXR AP (left) shows a hemivertebra at L1 causing spinal curvature convex left. Transverse US of the pelvis (above right) shows in the midline anteriorly an anechoic fluid-filled bladder with a round echogenic stool-filled rectum posterior to it while a transverse US of the perineum (below right) shows a very short distance between the calipers superiorly on the skin and inferiorly on the anterior wall of the rectum.
