Abstract
Background: Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC is a rare congenital disability. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. The decision to first approach is important for the next step. Herein, we reported a case of EEC with several anomalies. Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. The weight was 3300 grams, and the height was 48 centimetres. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. A complete dorsally opened urethral plate was seen from the bladder neck down to the glandular grove. The patient was diagnosed with Exstrophy-epispadias complex (EEC). A 2 stage repair was conducted in this patient. After 10 days post-operation, the wound became dehiscence and got sepsis postoperatively as well as lead to die in the day 20.Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC.
Highlights
Exstrophy-epispadias complex (EEC) is a congenital anomaly of the genitourinary system with congenital malformations ranging from isolated epispadias to classical bladder exstrophy, and cloacal exstrophy is the most severe presentation.[1]
EEC is caused by a derangement in mesodermal layers fusion during the first weeks of fetal life.[3]
Tension-suture and spica cast application in exstrophy-epispadias complex reconstruction has not been well documented. Based on those mentioned above, this study aims to evaluate the case report in showing the pitfall following EEC operation
Summary
Exstrophy-epispadias complex (EEC) is a congenital anomaly of the genitourinary system with congenital malformations ranging from isolated epispadias to classical bladder exstrophy, and cloacal exstrophy is the most severe presentation.[1]. EEC can be diagnosed prenatally with fetal transabdominal ultrasound (US) between the 15th and 32nd weeks of pregnancy.[2,3]. Exstrophy-epispadias complex (EEC) represents a spectrum of genitourinary malformations and associated with another congenital anomaly. EEC affects the genitourinary system, anterior abdominal wall, musculoskeletal system, spine and anus. The surgical outcome has a lot of potential complications in patient with EEC. We reported a case of EEC with several anomalies. Case Description: A new-born male was born with section cesarean at 38 weeks of gestation from 34-year-old mother, and this is from the second pregnancy. There was an abdominal wall defect with an exposed evaginated bladder plate with urine draining from the defect. The patient was diagnosed with Exstrophy-epispadias complex (EEC). Conclusion: Wound dehiscence following reconstruction is very critical inpatient with EEC. Tension suture and spica cast application can be disadvantageous inpatient with EEC
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