title: Intraperitoneal Bladder Perforation and Life-threatening Renal Failure in a Neonate Following Circumcision With the Plastibell Device.
abstract: We present the case of an infant who suffered intraperitoneal bladder perforation secondary to routine neonatal circumcision with the Plastibell device. On day-of-life 5, the patient presented with abdominal distention, vomiting, diarrhea, and severe acute renal failure. After removal of a distal meatal obstruction caused by the Plastibell device and open repair of the bladder defect, the patient had an uneventful recovery with rapid return of renal function. Despite the relative safety of the Plastibell, this case underscores the importance of careful device placement, parental education, keen clinical judgment, and prompt intervention when indicated.
authors.affiliation: Childrens Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Moira
authors.initials: M
authors.lastname: Dwyer
authors.affiliation: Temple University Health System, Philadelphia, PA. Electronic address: nathan.peffer@tuhs.temple.edu.
authors.forename: Nathan
authors.initials: N
authors.lastname: Peffer
authors.affiliation: Childrens Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuller
authors.affiliation: Childrens Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh Medical Center, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Cannon
mesh_terms: D002944:Circumcision, Male / Q000009:adverse effects* / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D051437:Renal Insufficiency / Q000209:etiology*; D012720:Severity of Illness Index; D001743:Urinary Bladder / Q000293:injuries*