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Picture of the Month

Sydney S. Gellis, MD; Murray Feingold, MD; Damien Pomerleau, MD; Pierre Gurmond, MD; Forrest Moyer, MD
Am J Dis Child. 1973;126(4):493-494. doi:10.1001/archpedi.1973.02110190405009.
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Denouement and Discussion 

Sirenomelia (Sirenomelus, "Mermaid Baby", Sympodia, Caudal Regression Syndrome) 

Manifestations  Major manifestations consist of fusion of the lower limbs, lumbosacral vertebral abnormalities, renal agenesis with oligoamnios and Potter facies, and imperforate anus.With the fusion of the legs there may be no feet (sirenomelia apus), one foot (sirenomelia monopus), or both feet (sirenomelia dipus) present. The fusion of the lower limbs and the abnormalities of the feet give the infant the appearance of a mermaid. The feet are often rotated and the patella may be located posteriorly. There are a variety of vertebral abnormalities, including absence of the sacrum. Genitourinary abnormalities occur frequently with renal agenesis the most common, followed by horse-shoe-shaped or rudimentary kidneys, and absence of the ureter or bladder. Because of the renal agenesis, a Potter facies (large, floppy low-set ears, flat nose, and micrognathia) is frequently present. The external genitalia are usually absent or present as a small raised nubbin of skin, which represents a


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