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BMJ Case Reports 2018; doi:10.1136/bcr-2018-226274
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Enterolithiasis in posterior urethral diverticulum: an uncommon complication following surgery for anorectal malformation

  1. Deepak Bagga3
  1. 1Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Pediatric Surgery, Lady Hardinge Medical College, New Delhi, Delhi, India
  3. 3Pediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India
  1. Correspondence to Dr Kashish Khanna, kash.modern{at}gmail.com
  • Accepted 22 August 2018
  • Published 12 September 2018

Description 

A posterior urethral diverticulum (PUD) may be formed when a part of the terminal rectal stump is left attached to the posterior urethra during fistula ligation in surgery for anorectal malformation (ARM).

A 13-year-old boy presented with the complaints of burning micturition, postvoid dribbling and vague pain in the left lower abdomen for the last 4 months. The child had high ARM and underwent all three stages of surgery (colostomy, transabdominal pull-through procedure and colostomy closure) elsewhere. On evaluation, the plain X-ray pelvis showed huge, multiple radio-opaque shadows in the region of the bladder (figure 1A). On an ultrasound, these acoustic shadows caused by the stones appeared to be posterior to the bladder and could not be appreciated well in full bladder state. A CT scan further confirmed these radio-opaque shadows to …

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