Bladder wall necrosis in an extremely low-birth-weight infant: a thought-provoking complication of necrotizing enterocolitis.
An 879-g baby boy had catastrophic necrotizing enterocolitis (NEC) at 29 days of life and underwent surgical laparotomy with a subsequent ileostomy and peritoneal drain placement. The infant was subsequently stable until 42 days of life when a spontaneous perforation of the bladder apex was diagnosed by a suprapubic cystogram. Laparotomy on day of life 46 found a loop of dead bowel herniating into a necrotic hole of the bladder dome. This case shows a previously unreported complication of NEC and discusses the possibility that prolonged use of a peritoneal drain may have permitted its genesis.
Swanson
Jonathan R
JR
Department of Pediatrics, University of Virginia Health System, Charlottesville, VA 22908, USA.
Ciambotti
Jonathan M
JM
Rodgers
Bradley M
BM
Roth
Jonathan A
JA
Gordon
Phillip V
PV
D001284:Atrophy; D003646:Debridement; D020345:Enterocolitis, Necrotizing / Q000150:complications*; D017809:Fatal Outcome; D006547:Hernia / Q000209:etiology; D006801:Humans; D007081:Ileostomy; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007249:Inflammation; D007422:Intestines / Q000473:pathology*; D007813:Laparotomy; D008297:Male; D009336:Necrosis; D010529:Peritoneal Cavity; D012778:Short Bowel Syndrome / Q000209:etiology*; D013396:Suction / Q000009:adverse effects*; D001743:Urinary Bladder / Q000473:pathology* / Q000601:surgery