RESUMO
Background: The most commonly used technique in the management of hydrocephalus is a neurosurgical procedure, known as ventriculoperitoneal shunt (VPS). Several complications of the distal end of a VPS catheter have been described in the literature, although migration and erosive bladder perforation of this shunt are extremely uncommon. Case Description: We relate a rare pediatric case of a 4-year-old boy, with long-term dysuria, intermittent incontinence, and chronic abdominal pain developed during a myelomeningocele postoperative period, without other symptoms. A bladder fistula with the distal end of the VPS inside the bladder was observed while performing an ultrasound to investigate the urinary tract. Two months before the current surgical approach, the patient, with hydrocephalus and alterations compatible with Chiari malformation, was treated with VPS and subsequently subjected to the third ventriculostomy. The child was unsuccessfully treated with an infraumbilical laparotomy, with section and careful traction of the catheter. A vesicostomy was then performed and the catheter was observed to form an intravesical knot. Conclusion: The intravesical knot formation is extremely rare and its mechanism of formation is still not well understood. Patients with VPS need adequate medical follow-up to identify possible complications of the shunt.
RESUMO
Spontaneous rupture of the urinary bladder represents a rare condition that may complicate with paravesical abscess. Although Staphylococcus aureus may be a part of the intestinal tract flora, it is an unusual cause of abdominal or pelvic abscesses. We report the case of a male patient with spontaneous bladder perforation with osteomyelitis and paravesical abscess, secondary to community-acquired methicillin-resistant Staphylococcus aureus infection.
RESUMO
Bladder rupture is a rare complication of transurethral resection of the prostate (TURP) or bladder (TURB). Both extra and in- traperitoneal perforation have an incidence of 1.3% in patients undergoing this procedure, and only 17% of these perforations turn out to be intraperitoneal[],[]. It is a serious complication that requires immediate treatment to prevent it from progressing to peritonitis uremia, acidosis, and compartment syndrome.
La rotura vesical es una complicación poco común de la resección transuretral de próstata (RTUP) o vejiga (RTUV). La perforación tanto extra como intraperitoneal tiene una incidencia de 1,3% en los pacientes sometidos a este procedimiento y solo el 17% de dichas perforaciones resultan ser intraperitoneales. Es una complicación grave que requiere tratamiento inmediato para evitar que progrese a peritonitis, uremia, acidosis y síndrome compartimental.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Bexiga Urinária/lesões , Ressecção Transuretral da Próstata/efeitos adversos , Complicações Intraoperatórias/etiologia , Peritonite/prevenção & controle , Acidose/prevenção & controle , Tomografia Computadorizada por Raios X , Hipertensão Intra-Abdominal/prevenção & controle , Complicações Intraoperatórias/terapia , Complicações Intraoperatórias/diagnóstico por imagemRESUMO
Se estima que en el mundo cerca de 160 millones de mujeres son usuarias de dispositivos intrauterinos (DIU), siendo Chile uno de los países con más alta tasa, con cerca del 70 por ciento de las usuarias en el sistema público. Sin embargo, su uso no está exento de complicaciones. Presentamos un caso infrecuente de DIU intravesical en expulsión en gestante de 28 semanas.
In the world, about 160 million women are users of intrauterine devices (IUD); Chile is one of the countries with the highest rate, with about 70 percent of users in public system. However, its use may be complications. We present an unusual case of intravesical IUD expulsion in 28 weeks pregnant.