A foreign body in the urinary bladder leads to bladder stone and vesicorectal fistula: A case report

The case in this study was presented, the features in the diagnosis and treatment of rare complications such as bladder stone and vesicorectal fistula caused by the injection needle, which is a foreign body in the bladder. A 1-year-old male child came to our outpatient department with chief complaints of straining during micturition, dribbling of urine and history of high-grade fever, chills & rigor. A kidney, ureter, and bladder (KUB) X-ray revealed an approximately 1.5 cm bladder stone with radiopaque linear foreign body. On diagnostic cystoscopy anterior, posterior urethra was normal, fecal debris, stone and a needle was seen coming out through posterior wall of bladder. Open anterior cystolithotomy was done to remove 1.5-cm stone and a foreign body described as injection needle 24 gauge surrounded with fecal debris coming out through posterior wall was also removed. Fistulous tract was present and probed with 5 Fr feeding tube. A diversion colostomy was done. Patient discharged with colostomy and in follow up after 1 month micturating cystourethrogram (MCU) and distal loopogram of colon were normal; no fistulous communication present. Colostomy was closed after 3 months. There has been many cases reported in literature about insertion of different foreign bodies in bladder but foreign body ( injection needle) leading to bladder stone and vesicorectal fistula  is first of its kind as far as our knowledge is concerned

Detubularized isolated ureterosigmoidostomy in a complicated common cloaca: A case report

Urinary incontinence in a child secondary to a severe congenital anatomical disorder or due to complication of a previous surgery can be difficult to manage. Decisions can be especially hard when a redo procedure is being considered. We present one such case where a 6 year old girl previously operated for cloaca was brought with incontinence and after much consideration of options available, underwent a modified ureterosigmoidostomy to aid in her continence. The modification used was detubularized isolated ureterosigmoidostomy, described by Atta et al in 1996

Reflections on Covid19 nasopharingeal, faecal and peritoneal swabs in an infant with Wilms tumor: A case report

Proximal Sars-Cov-2 pandemic had radically changed the way surgeons work in many departments, forcing to reserve surgical treatment only for emergency and oncologic cases. We report a case of a ten months-old girl with right-sided Wilms tumor and a previous diagnosis of Sars-Cov-2 infection, who underwent open right nephrectomy. Surgery was planned after negativization of five nasopharyngeal tests, despite the simultaneous positivity of two rectal swabs. The procedure was performed safely with appropriate personal protective equipment (PPE). To better investigate viral excretion, the anesthetist repeated nasopharyngeal swab under general anesthesia, which resulted positive. At the same time, two peritoneal swabs were collected and showed the absence of the virus in the peritoneal fluid. This case highlights the importance of combining swabs from various sources to increase sensibility of the test. The value of nasopharyngeal swab under general anesthesia should be reinforced as it can result positive even after many negative tests. Very little is known abouttransmission of the virus through the peritoneum as both presence and absence of Sars-Cov-2 have been reported in the peritoneal fluid. Next literature will clarify which particular conditions determine viral penetration in this anatomical district

Cystic nephroma with renal vein thrombus in a child with DICER1 mutation: A case report

Venous tumor thrombus is a known manifestation of Wilms’ tumors in a minority of cases but has not been previously described in association with cystic nephroma.  We report an original case of a histologically-benign cystic nephroma presenting with venous tumor thrombus extending to the inferior vena cava.  The tumor thrombus was not detected by preoperative Doppler ultrasound.  The patient was successfully treated with radical nephrectomy, tumor thrombectomy, and IVC closure.  Postoperatively, the patient underwent genetic testing which revealed a DICER1 mutation—known to predispose affected individuals to a variety of benign and malignant tumors—and requires intensive surveillance for associated conditions

A case of perinephric abscess in a child with diabetes mellitus: A rare manifestation of group B Streptococcal infection

Perinephric abscess is an uncommon infection in children, but it is usually caused by Escherichia coli, Staphylococcus aureus, Proteus mirabilis and Pseudomonas aeruginosa. Group B Streptococcus (GBS) is an uncommon cause of perinephric abscess or serious bacterial infections beyond the neonatal period. Comorbid conditions such as diabetes mellitus and immunosuppression can increase the risk of GBS invasive disease. We describe a 10-year-old female who presented with 1-month of right-sided flank pain and swelling with ultrasound showing large (>3 cm) right perinephric and subcutaneous abscesses. She was additionally diagnosed with new onset type 2 diabetes mellitus (DM) during admission. Abscess cultures obtained after placement of two percutaneous drains and the initiation of broad-spectrum intravenous antibiotics grew beta-hemolytic GBS. Here, we present to our knowledge, the first known documented case of GBS perinephric abscess in a school-aged child with DM. Much of the knowledge of perinephric abscess management is extrapolated from adults, therefore making optimal treatment in the pediatric population challenging. We propose that GBS be considered in the etiology of perinephric abscess in children with DM and other immunosuppressing conditions. In addition, percutaneous drainage of larger abscesses (>3 cm) in conjunction with antibiotic therapy is a reasonable management strategy

Cystic lymphangioma: A rear finding during hydrocele surgery in children “case report”

Cystic lymphangioma is a benign, unencapsulated tumor caused by congenital malformations of the lymphatic system. It is a rare type of hematoma that unusually causes scrotal swelling. A 3-year-old boy presented with a painless swelling in his right hemiscrotum that gradually increased over a year. The swelling was clinically evaluated as a hydrocele, but a multi-localized cystic mass filled with hemorrhagic fluid was detected on surgical exploration. A complete excision was made and histopathological evaluation revealed cystic lymphangioma. As a result, cystic lymphangioma mimicking hydrocele can be seen in children. Although it is a rare type of tumor, this pathology should be suspected during the surgical operation in the groin area

Epididymo-orchitis caused by Behcet’s disease: An unusual cause of acute scrotum

Behçet’s disease (BD) is a rare systemic inflammatory disorder of the blood vessels and tissues.  It is rarely seen in children. The clinical course of the disease in children is similar to that of the adults by symptoms such as recurrent oral ulcers, genital ulcers and ocular inflammation. Additionally, urological manifestations rarely seen in BD.  Here we present two children with BD and epididymo-orchitis confusing with testicular torsion. Since BD is rarely observed in children, it is very difficult to diagnose the patients with epididymo-orchitis. Treatment for the testicular torsion is immediate surgical therapy to prevent the testicular necrosis. On the other hand epididymo-orchitis caused by BD should be treated medically. Unnecessary surgery on BD patient can affect morbidity negatively.  We aimed to take attention to this rare condition to prevent the patients from unnecessary operation

Epidermoid inclusion cyst after urethroplasty: A rare complication

Epidermoid inclusion cysts (EIC) is a disease caused by the nidation of the epidermal tissues and sebaceous materials into the dermal and subcutaneous layers. This entity is usually observed after trauma and surgical procedures. A 5-year-old boy with a ventral penile mass was admitted to our department. The history of the patient revealed that he was operated at the age of 1 year for hypospadias in a different medical center. The patient’s history also revealed that during the initial operation, a skin graft was used for covering urethroplasty. One year later the operation, a ventral penile mass was observed by his mother during wash. The mass continued to increase in size reaching of 1 cm in diameter. The mass was excised and the histopathological study revealed that the mass was compatible with an EIC. With 2 years of follow up the patient is disease free. EICs after penile surgical interventions may be a factor of anxiety for both the children and their parents. In order to avoid this unwanted complication, implantation of the superficial tissue layers into the deep the dermal and subcutaneous tissues should be avoided

Fournier's gangrene with urethral involvement in a four-year-old child with neuropathic bladder: A rare case report

A four-year-old boy presenting with neuropathic bladder and hydrocephalus developed Fournier’s gangrene of the scrotum and perineum. At first, he was in septic shock and intubated. After debridement and grafting, he was taken to the normal service room from the intensive care unit. He was discharged on the 29th postoperative day. We performed bilateral orchiectomy due to testicular involvement and also repair and flap application to urethra due to its involvement. We think that our case is interesting because Fournier’s gangrene is already rare in children and our case also contains atypical involvement sites such as testes and urethra.

Post traumatic isolated and complete bladder neck horizontal transection: A case report and literature review

Isolated bladder neck horizontal transection without bladder or prostatic involvement is very rare in pediatric age group. To our knowledge, this is the first case of such trauma reported in Malaysia. In this article, we present a case of primary suprapubic catheter insertion with delayed vesicoprostatic urethral anastomosis in the treatment of complete bladder neck horizontal transection