Bladder Necrosis at Time of Presentation with Ulcerative Colitis in an 8-year-old Female: A Case Report
Bruce J Schlomer1, Nicholas Norris2, Bhaskar Gurram2
1Department of Urology, University of Texas Southwestern, Dallas, TX.
Insights
This case report details a rare instance of bladder necrosis in a pediatric patient with ulcerative colitis (UC). The condition required surgical intervention, including urinary diversion, highlighting a severe complication of UC in children.
Area of Science:
- Pediatric Gastroenterology
- Urology
- Gastroenterology
Background:
- Ulcerative colitis (UC) is a chronic inflammatory bowel disease.
- Bladder necrosis is a rare and severe complication, particularly in pediatric patients outside the neonatal period.
Observation:
- An 8-year-old female presented with acute symptoms including abdominal pain, bloody stools, hematuria, and acute renal failure.
- Initial management involved bilateral nephrostomy tube placement for acute renal failure.
Findings:
- Biopsies confirmed ulcerative colitis (UC) and bladder necrosis.
- Medical management of UC was initiated.
- The necrotic bladder did not regenerate, necessitating an ileal conduit urinary diversion.
- A concomitant right proximal ureteral stricture was addressed with pyeloplasty.
Implications:
- This case highlights bladder necrosis as a potential, albeit rare, severe complication of ulcerative colitis in pediatric patients.
- The successful surgical management underscores the importance of multidisciplinary care involving gastroenterology and urology.
- Long-term follow-up is crucial for patients with such severe UC-related complications.
Abstract:
A case of bladder necrosis in an 8-year-old female at time of presentation of ulcerative colitis (UC) is presented. A case of bladder necrosis in a pediatric patient outside of the neonatal period has not been reported. The patient presented with abdominal pain, bloody stools, hematuria, and acute renal failure. She was acutely management with bilateral nephrostomy tube placement. Bladder and colon biopsies revealed diagnosis of UC and bladder necrosis. The UC was medically managed. The bladder did not regenerate after several months of observation and ileal conduit urinary diversion was performed. A right proximal ureteral stricture was managed by pyeloplasty at time of ileal conduit. The patient is doing well over 1 year after surgery.
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