Variant of Bladder Exstrophy 2 (Differential Diagnosis)
4-month-old boy with an externally recognizable malformation of the pubic region which also differs clinically from a typical bladder exstrophy. An annular dent of the skin is situated in the midline of the lower abdomen and is covered partially by skin and partially by a mucous membrane. Caudally, there are abnormal skin structures with a blind-ending fistula and a groove at the dorsal side of the penis. So far, the infant has had a normal micturation.
The diagnosis is exstrophic double-bladder. The yellow catheter enters the bladder by a normal urethra. Divided from the latter there are remnants of a bladder and urethra (annular dent and blind-ending fistula).
The low position of the insertion of the navel, the distally situated defect of the abdominal wall, and the abnormal external genitals are general signs of the differentiation of the bladder exstrophy complex from a gastroschisis or an omphalocele.
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