Vesico-Peritoneal Fistula As A Rare Cause Of Peritonitis In Guillain-Barre Syndrome: A Case Report
- Eriawan Agung Nugroho ,
- Dimas Susilo Waridiarto ,
- Nanda Daniswara ,
- Sofyan Rais Addin ,
- Dimas Sindhu Wibisono ,
- Ardy Santosa ,
Introduction: Guillain-Barre syndrome is the most common and most severe acute paralytic neuropathy with any clinical features. Some patients present with the neurogenic bladder in which bladder dysfunction happens, resulting in urinary retention. The delayed diagnosis often leads to some complications, including bladder perforation. Vesico-peritoneal is lined by epithelial cells that communicate between the peritoneal cavity and the urinary bladder. In this location, can occur a fistula called vesico-peritoneal fistula. This type of fistula leads to peritonitis with high morbidity and mortality.
Case description: A 22- year- old female was admitted to a neurologist with lower extremities paralysis. The surgery department then consulted the patient for suspicion of generalized peritonitis. The patient had a history of taking medication for Guillain-Barre syndrome and complaint of abdominal pain, bloating, nausea, hematemesis, and hematuria. The abdominal radiograph showed pneumoperitoneum. The patient received antibiotics and underwent exploratory laparotomy. Exploratory laparotomy revealed vesico-peritoneal fistula. In this case, the defect was achieved by dissection of the fistulous tract and the primary closure of the bladder. Postoperative follow-up indicated no sign of complication.
Conclusion: Fistulation between the bladder and peritoneal in GBS could cost high morbidity and mortality. Dissection of the fistulous tract and primary closure of the bladder could overcome this condition without any concerning complications.