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Related Experiment Videos

Delayed bladder rupture after augmentation enterocystoplasty.

H G Rushton1, J R Woodard, T S Parrott

  • 1Division of Urology, Emory University School of Medicine, Atlanta, Georgia.

The Journal of Urology
|August 1, 1988
PubMed
Summary
This summary is machine-generated.

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Delayed bladder perforation after enterocystoplasty in children with spina bifida is a severe complication. Early diagnosis and intervention are crucial to prevent life-threatening peritonitis and sepsis.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Gastroenterology

Background:

  • Augmentation enterocystoplasty is a procedure to enlarge the bladder, often for children with spina bifida and neuropathic bladders.
  • Undiversion procedures using tubular colonic segments are common in managing these complex cases.
  • Intermittent self-catheterization is a standard management for patients post-enterocystoplasty.

Observation:

  • Four cases of delayed bladder perforation with peritonitis following augmentation enterocystoplasty in children with spina bifida are presented.
  • Patients had undergone enterocystoplasty with a tubular colonic segment and managed with intermittent self-catheterization.
  • The time from surgery to presentation varied from 6 months to 3 years.

Findings:

  • Diagnosis was delayed in all reported cases.

Related Experiment Videos

  • Cystogram studies were normal in 3 patients despite evidence of urine extravasation during surgical exploration.
  • One patient developed generalized sepsis and respiratory distress syndrome, ultimately succumbing to the complication.

    • Implications:

    • This case series highlights the potential for delayed, life-threatening complications after augmentation enterocystoplasty.
    • The findings underscore the importance of high clinical suspicion for bladder perforation, even with normal imaging.
    • Improved diagnostic strategies and timely surgical intervention are critical for improving outcomes in these vulnerable patients.