Management of delayed bladder augmentation perforation.

BACKGROUND

A 17-year-old male, with a history of bladder augmentation enterocystoplasty 7 years earlier, presented with nausea, emesis and acute abdomen.

INVESTIGATIONS: Physical examination, blood and urine culture, and abdominal and pelvic CT cystography.

DIAGNOSIS: Acute abdomen from perforation of bladder augmentation.

MANAGEMENT: Support and stabilization, bladder decompression, and broad-spectrum intravenous antibiotics, followed by immediate exploratory laparotomy with repair of enterocystoplasty and peritoneal lavage.