Perforation and intravesical erosion of a ventriculoperitoneal shunt in a child with an augmentation cystoplasty.
Bladder augmentation has evolved into a common method of management in children with a low capacity and/or poorly compliant bladder secondary to a neuropathic condition. We report on a 4-year-old girl with myelodysplasia who presented with sepsis and who had a perforation of the augmented bladder, which was surgically repaired. She returned for evaluation 1 month after she was discharged from the hospital when the distal component of the ventriculoperitoneal shunt was noted to protrude per urethram after clean catheterization. Distal shunt replacement with prolonged bladder drainage successfully resolved this perforation of the augmented bladder. The patient has had no further difficulties. We discuss the diagnosis and management of this case with reference to the current literature regarding complications of augmentation cystoplasty.
Mevorach
R A
RA
Department of Urology, University of Rochester Medical Center, New York 14642.
Hulbert
W C
WC
Merguerian
P A
PA
Rabinowitz
R
R
D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D005548:Foreign-Body Migration; D006801:Humans; D009436:Neural Tube Defects / Q000601:surgery; D010529:Peritoneal Cavity; D014521:Urethra; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D014950:Wounds, Penetrating / Q000209:etiology*