RESUMO
We present a rare case of a vesicocutaneous fistula secondary to two large bladder calculi in a patient with spina bifida. A 62 year old lady presented with swelling of her right thigh and a calcified mass protruding through the subcutaneous tissues of her right groin. Urine was seen to be draining from around the area and plain radiographs and a computed topography (CT) scan confirmed the presence of two bladder calculi with a vesicocutaneous fistula. Vesicolithotomy was performed and the fistula tract left to close spontaneously. Worldwide this is only the fourth case of a bladder calculus causing a vesicocutaneous fistula.
RESUMO
OBJECTIVE: To assess the incidence of ectopic adrenocortical tissue (EACT) in the groin in children, and examine the relationship between the incidence and the underlying diagnosis, age and sex. PATIENTS AND METHODS: From computer records, all groin explorations between 1988 and 2002 in patients < or = 15 years old were identified. Cases of EACT were identified from computer histology records, and the incidence in different groups compared. RESULTS: Of 935 groin explorations, EACT was identified in 25 (2.7%); there were no cases in girls. The incidence was 0.7% at inguinal herniotomy (IH), 4.1% at ligation of the patent processus vaginalis for communicating hydrocele (P = 0.03 vs IH), and 3.3% at exploration for undescended testes (P = 0.02 vs IH). In boys with undescended testes the incidence of EACT was similar in different age groups (0-7 years, 3.3%; 8-15 years 3.2%, P = 0.96). CONCLUSIONS: The overall incidence of EACT at groin exploration was 2.7%, with none detected in girls. There was no evidence of involution of EACT with increasing age. The incidence of EACT varied with the underlying diagnosis, but the reason for this is unknown.
