Abbak Alshahid A, Khoshhal Khalid I
Consultant Pediatric Orthopedic Surgeon, King Fahad Medical City, Riyadh, Saudi Arabia, E-mail address:
Int J Health Sci (Qassim). 2012 Jun;6(2):240-4. doi: 10.12816/0006003.
Bladder exstrophy is a very rare congenital disorder, in which the first stage of reconstruction is usually performed within the first 72 hours of life. The most feared form of failure of the reconstruction is postoperative dehiscence of the bladder and abdominal wall. We present an 11-year-old girl with bladder exstrophy. She underwent three iliac bone supra-acetabular osteotomies with repair of the bladder exstrophy. Unfortunately the diastasis of the symphysis recurred widely open with dehiscence of bladder and abdominal wall. Bilateral pubic and ischial rami osteotomies with adequate soft tissue release were carried out, which allowed the urology team to perform a tension-free repair of the bladder and the abdominal wall. Here we report an osteotomy with the soft tissue release that succesfully allowed the closure of the pelvis, bladder and anterior abdominal wall in a recurrent case with more than three years follow up.
膀胱外翻是一种非常罕见的先天性疾病，其重建的第一阶段通常在出生后的72小时内进行。重建失败最可怕的形式是术后膀胱和腹壁裂开。我们报告一名患有膀胱外翻的11岁女孩。她接受了三次髂骨髋臼上截骨术并修复膀胱外翻。不幸的是，耻骨联合分离再次广泛裂开，伴有膀胱和腹壁裂开。进行了双侧耻骨和坐骨支截骨术并充分松解软组织，这使得泌尿外科团队能够对膀胱和腹壁进行无张力修复。在此我们报告一种截骨术及软组织松解术，该方法成功实现了一例复发病例的骨盆、膀胱和前腹壁闭合，随访超过三年。
