Paediatric Surgery (Ukraine). 2025. 2(87): 128-135. doi: 10.15574/PS.2025.2(87).128135
Soleiko D. S.¹, Soleiko N. P.², Gorbatyuk O. M.³, Sapryha I. V.², Kurtash O. O.^4
1National Pirogov Memorial Medical University, Vinnytsya, Ukraine
²CNPE «Vinnytsya Regional Children's Clinical Hospital of the Vinnytsya Regional Council», Ukraine
³Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
⁴Ivano-Frankivsk National Medical University, Ukraine

For citation: Soleiko DS, Soleiko NP, Gorbatyuk OM, Sapryha IV, Kurtash OO. (2025). Clinical case of abscess of the posterior wall of the urinary bladder in a 3-year-old patient. Diagnostic and treatment tactics. Paediatric Surgery (Ukraine). 2(87): 128-135. doi: 10.15574/PS.2025.2(87).128135.
Article received: Jan 28, 2025. Accepted for publication: Jun 10, 2025.

Intra-abdominal inflammatory formations of the abdominal cavity in children are a complication of inflammatory processes of various organs, one of which may be the bladder. Untimely determination of the anatomical localization of the inflammatory focus is one of the reasons for the incorrect diagnosis, hypodiagnosis, and the choice of treatment tactics that are not radical in relation to the etiology of the disease.
Aim – description of symptoms, determination of diagnostic measures and complex treatment of abscess of the bladder wall in children based on a clinical case.
The clinical case demonstrates the tactics of diagnosis and treatment in a 3-year-old patient with an abscess of the posterior wall of the bladder. Analysis of the course of the disease and the diagnostic and treatment process proved the reasons for determining the incorrect diagnosis, improperly etiology and localization of the inflammatory focus, the dynamics of the course of the disease, and treatment tactics at the first stage of treatment, which became the reason for the untimely surgical intervention. The need for multimodal diagnostic tactics in the visualization of inflammatory formations of the abdominal cavity is determined and proven. The diagnostic value and feasibility of using additional examination methods are analyzed. Differential diagnosis of bladder wall abscess with urachus anomalies is presented. Conservative and surgical treatment tactics are determined.
Conclusions. The structure of inflammatory infiltrates/abscesses of the abdominal cavity in children is polyetiological. One of the causes of the occurrence of an infiltrate/abscess of the abdominal cavity is the inflammatory process of the bladder wall. The presence of an infiltrative formation of the abdominal cavity requires multimodal diagnostic tactics immediately after determining the diagnosis and hospitalization – performing magnetic-resonance imaging (if it is impossible to perform it – computed tomography with contrast) and ultrasound of the abdominal organs, in order to determine its etiology, localization, nature and structure of pathological changes, the possible presence of abscessation, location relative to other anatomical structures. The presence of an infiltrate/abscess of the bladder wall requires differential diagnosis with complicated anomalies of the urachus, other developmental defects, tumor-like formations. The presence of a bladder wall abscess in a pediatric patient is an indication for perfoming fibroureterocystoscopy under general anesthesia to determine possible presence of changes in the mucosa, congenital malformations, and tumor-like formations of the bladder.
The research was carried out in accordance with the principles of the Helsinki Declaration. Informed consent was obtained from parents of the child.
The authors declare no conflict of interest.
Keywords: abdominal cavity infiltrate, abdominal cavity abscess, posterior bladder wall abscess, diagnostics, treatment, children.

REFERENCES

1. Abdullatif VA, Novack J, Shalhoub PJ, Campbell TG, Abbott JE. (2022). A rare case of a bladder neck abscess masquerading as a benign mass. Case Reports in Urology. 2022: 9966553. https://doi.org/10.1155/2022/9966553; PMid:36246551 PMCid:PMC9553506

2. Alfarizi ZY, Subekti E, Danarto, Yuri P. (2024). A rare case of spontaneous bladder wall abscess mimicking bladder tumour in young women. BMC Urology. 24(1): 109. https://doi.org/10.1186/s12894-024-01497-6; PMid:38762447 PMCid:PMC11102172

3. Briggs KB. (2023, Apr 10). Patent urachus. StatPearls [Internet]. URL: https://www.ncbi.nlm.nih.gov/books/NBK557723/.

4. Chen C-Y, Lin M-J, Yang W-C, Chang Y-J, Gao F-X, Wu H-P. (2020). Clinical spectrum of intra-abdominal abscesses in children admitted to the Pediatric Emergency Department. Journal of Microbiology, Immunology and Infection. 53(2): 283-291. https://doi.org/10.1016/j.jmii.2018.07.003; PMid:30150137

5. Das JP, Vargas HA, Lee A, Hutchinson B, O'Connor E, Kok HK et al. (2020). The urachus revisited: Multimodal imaging of benign & malignant urachal pathology. The British Journal of Radiology. 93(1110): 20190118. https://doi.org/10.1259/bjr.20190118; PMid:32045264 PMCid:PMC10993214

6. Flaus A, Longo M-G, Dematons M, Granjon D, Prevot N. (2019). 18F-FDG PET/CT in urachal abscess. Clinical Nuclear Medicine. 44(5): e349-e350. https://doi.org/10.1097/RLU.0000000000002524; PMid:30829865

7. Kamel K, Nasr H, Tawfik S, Azzam A, Elsaid M, Qinawy M et al. (2023). Complicated urachal cyst in two pediatric patients: A case report. BMC Pediatrics. 23(1): 147. https://doi.org/10.1186/s12887-023-03962-x; PMid:37004016 PMCid:PMC10064585

8. Loertzer H, Hohne SO, Finke R, Fornara P. (2005). Intramural bladder-wall abscess: A late complication arising after a urethrocystoscopy? Pediatric Surgery International. 21(4): 323-325. https://doi.org/10.1007/s00383-004-1348-7; PMid:15645251

9. Quinn V, Luks F, Constantine E. (2022). Infected urachal cyst masquerading as acute appendicitis on point-of-care ultrasound. Clinical Practice and Cases in Emergency Medicine. 6(2): 186-188. https://doi.org/10.5811/cpcem.2022.1.55243; PMid:35701355 PMCid:PMC9197745

10. Saito JM. (2012). Beyond appendicitis. Current Opinion in Pediatrics. 24(3): 357-364. https://doi.org/10.1097/MOP.0b013e328352704e; PMid:22450248

11. Simões e Silva AC, Oliveira EA, Mak RH. (2020). Urinary tract infection in pediatrics: An overview. Jornal de Pediatria. 96: 65-79. https://doi.org/10.1016/j.jped.2019.10.006; PMid:31783012 PMCid:PMC9432043

12. Soleiko DS, Soleiko NP, Gorbatyuk OM, Kharchuk LY, Biletska NE. (2024). A clinical case of tuberculous rib damage as an etiological cause of chest neoplasm in an early age child. Paediatric Surgery (Ukraine). 4(85): 130-135. https://doi.org/10.15574/PS.2024.4(85).130135

13. Theilen T-M, Rolle U. (2023). Akutes abdomen im Kindesalter. Medizinische Klinik – Intensivmedizin Und Notfallmedizin. 118(8): 619-625. https://doi.org/10.1007/s00063-023-01030-x; PMid:37294351 PMCid:PMC10252174