Delayed bladder rupture after augmentation enterocystoplasty.
Delayed bladder perforation with peritonitis following augmentation enterocystoplasty in children with spina bifida is a serious and potentially life-threatening complication. Our experience with 4 such cases is presented. All patients had spina bifida with a neuropathic bladder and they had undergone augmentation enterocystoplasty with a tubular colonic segment of large bowel as part of an undiversion procedure. All patients were being managed with intermittent self-catheterization. The interval from augmentation enterocystoplasty until presentation ranged from 6 months to 3 years. Diagnosis was delayed in all cases, including 3 in which cystogram studies were normal despite findings of extravasation of urine at exploration. In 1 patient generalized sepsis developed with the respiratory distress syndrome and, subsequently, she died.
Rushton
H G
HG
Division of Urology, Emory University School of Medicine, Atlanta, Georgia.
Woodard
J R
JR
Parrott
T S
TS
Jeffs
R D
RD
Gearhart
J P
JP
D000293:Adolescent; D002648:Child; D003559:Cystostomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D010538:Peritonitis / Q000209:etiology; D011859:Radiography; D012422:Rupture, Spontaneous; D016136:Spina Bifida Occulta / Q000150:complications; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000601:surgery