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Recurrent Painless Haematuria in a Well Child—A Case Report

Lookup NU author(s): Dr Christian Harkensee, Alok Godse

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© Association of Surgeons of India 2024. We report a case of appendico-vesical fistula (AVF) in a 12-year-old boy presenting with a 2-month history of solely recurrent painless macroscopic haematuria. Ultrasound and MRI scans were suggestive of an urachus remnant with a calculus in the bladder dome. Cystoscopy showed a bladder diverticulum with mucosal inflammation. Open laparotomy eventually revealed the AVF, as a complication of a clinically ‘silent’ acute appendicitis. AVF is a rare complication of acute appendicitis. A literature review identified 17 further paediatric cases. Whilst faecaluria and pneumaturia are pathognomonic for AVF, these were present in only 24% of patients. Most patients presented with recurrent urinary tract infections or urinary symptoms, and most had a history of abdominal pain and vomiting. Imaging studies and cystoscopy were often inconclusive, and most diagnoses were made at surgery. A high index of clinical suspicion helps to guide diagnosis and treatment.

Publication metadata

Author(s): Sahay R, Harkensee C, Godse A

Publication type: Article

Publication status: Published

Journal: Indian Journal of Surgery

Year: 2025

Volume: 87

Pages: 182-184

Print publication date: 01/02/2025

Online publication date: 17/04/2024

Acceptance date: 06/04/2024

Date deposited: 30/04/2024

ISSN (print): 0972-2068

ISSN (electronic): 0973-9793

Publisher: Springer Nature

URL: https://doi.org/10.1007/s12262-024-04075-0

DOI: 10.1007/s12262-024-04075-0

Data Access Statement: As this is a case report no systematic data collection was undertaken. All data from the literature review are presented in tables 1 and 2 and were directly extracted from the references supplied in appendix 1. There are no other available data

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