Archives of Physical Medicine and Rehabilitation
Volume 77, Issue 11 , Pages 1198-1200, November 1996

Spontaneous bladder perforation in paraplegia as a late complication of augmentation enterocystoplasty: Case report☆☆☆

Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio USA

Received 7 November 1995; accepted 5 February 1996.

Article Outline

Abstract 

The management of spinal cord injured (SCI) patients with small capacity, noncompliant bladders has focused on the preservation of renal function and social continence. When conservative management is unsuccessful, surgical intervention may prove beneficial. Augmentation enterocystoplasty is a reliable method of achieving increased bladder capacity while decreasing intravesical filling pressure. Spontaneous bladder rupture is a rare complication of augmentation enterocystoplasty. Because the urine is often colonized with bacteria, bladder rupture may result in chemical and bacterial peritonitis, which is associated with a 25% mortality rate. SCI patients may not present with the classic signs of an acute abdomen. Early diagnosis is critical so that aggressive management may be instituted. The case of late spontaneous perforation of an augmentation enterocystoplasty in a 33-year-old man with T7 complete paraplegia is presented, and the literature discussing the etiology, diagnosis, management, and prevention of augmented bladder perforation is reviewed.

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☆ Presented at the Scientific Poster Session at the 57th Annual Assembly of the American Academy of Physical Medicine and Rehabilitation, Orlando, FL, November 1995.

☆☆ No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

PII: S0003-9993(96)90148-3

Archives of Physical Medicine and Rehabilitation
Volume 77, Issue 11 , Pages 1198-1200, November 1996

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