A post-traumatic complication of transappendicular cystostomy: urinary peritonitis

Two children who had undergone a transappendicular urinary diversion (type Mitrofanoff) developed bladder rupture, one following abdominal trauma, 4 m onths after the operation and the other following traumatic self-catheteriz aton at 4 years. The clinical history and standard radiological examination s (ultrasonography, cystography) confirmed the diagnosis of urinary periton itis. Emergency surgical repair was possible in both cases with an uneventf ul postoperative course. This serious and rare complication requires emerge ncy surgery and justifies rigorous selection of children suitable for this type of diversion giving preference to increased bladder neck resistance ov er bladder neck closure.