ESPN 51th Annual Meeting

ESPN 2018


 
CLEAN INTERMITTENT CATHETERIZATION RELATED BLADDER PERFORATION IN CHILDREN: A CASE REPORT
DEMET ALAYGUT 1 CANER ALPARSLAN 1 SEÇİL ARSLANSOYU ÇAMLAR 1 EREN SOYALTIN 1 ALİ SAYAN 3 FATMA MUTLUBAŞ 1 BELDE KASAP DEMİR 2 ÖNDER YAVAŞCAN 1

1- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, IZMIR, TURKEY
2- IZMIR KATIP ÇELEBI UNIVERSITY DEPARTMENT OF PEDIATRICS DIVISION OF NEPHROLOGY, IZMIR, TURKEY
3- IZMIR TEPECIK TRAINING AND RESEARCH HOSPITAL DEPARTMENT OF PEDIATRIC SURGERY , IZMIR, TURKEY
 
Introduction:

Catheter-related bladder perforation is a very rare complication in patients undergoing clean intermittent catheterization (CIC). Presently described is the case of a 5-year-old female who had CIC treatment related bladder perforation.

Material and methods:

She has been diagnosed as neurogenic bladder (NB) due to operated neurospinal dysraphism. As a result of NB, she had undergone CIC treatment with the help of a relative of her. Five years after the initiation of treatment, the patient was admitted to the emergency room with urinary tract infection (UTI) symptoms such as fewer, cloudy urine. Urine dipstick and microscopy showed to UTI. Urine culture showed Acinetobacter baumanii and colimycin (5 mg/kg/day) treatment intravenously started. On the third day, fever did not occur, and the redness around the umbilicus was noticed. On the fifth day, the upper skin was ulcerated and separated about 4 cm. It was seen that urine drainage came from the separated area.  Bladder perforation was diagnosed by VCUG showed that contrast in the urinary bladder with ladder in the extraperitoneal spaces. Acinetobacter baumanii was also identified in umbilical discharge culture and colimycin treatment was intravenously continued. 

Results:

Mupirocin and nitrofurazone was topically added to colimycin treatment as well as patient was permanently catheterized. It was observed that all findings recovered after 4 weeks of this treatment. 

Conclusions:

The majority of complications associated with CIC are not critical, however severe complications such as bacteremia and bladder rupture can occur in several cases. Therefore, clinician should delicate observation of potential symptoms for the complication.