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Spontaneous bladder rupture secondary to posterior urethral valves in a boy with Down syndrome
  1. Massimo Garriboli1,2,
  2. Shimaa Ibrahim1 and
  3. Joanna Clothier1
  1. 1Department of Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2Stem Cells & Regenerative Medicine Section, Developmental Biology & Cancer Programme, UCL, London, UK
  1. Correspondence to Massimo Garriboli; m.garriboli{at}


We describe a case of a 3-year-old boy with Down syndrome who developed a bladder rupture as a consequence of an undiagnosed posterior urethral valve (PUV). He had a history of urinary tract infections and constipation and was acutely admitted in poor condition and underwent laparotomy that revealed peritoneal sepsis secondary to bladder perforation. Bladder was drained using a suprapubic catheter and the condition of the boy gradually improved. Once stable, a cystourethroscopy confirmed the presence of PUV. Video-urodynamic studies performed at the check cystoscopy showed the bladder to be of reduced compliance (end fill pressure at 100 mL fill 30 cmH2O) with raised voiding pressures (76–100 cmH2O) and significant incomplete bladder emptying. Currently, the patient is doing very well, serum creatinine has normalised, he is infection-free and thriving; his bladder is managed with a vesicostomy.

  • urinary tract infections
  • urological surgery
  • paediatric surgery
  • renal intervention
  • paediatrics (drugs and medicines)

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  • Contributors MG and JC: project development, manuscript writing and editing, and critical review; SI: manuscript writing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.