Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A Case of in-utero Vesicoamniotic Shunting and Postnatal Vesicostomy in Very Low Birth Weight Baby with Posterior Urethral Valve Syndrome

산전 방광 양막강 문합술(Vesicoamniotic shunt)과 출생 후 방광 조루술(Vesicostomy)을 실시한 극소 저출생 체중아의 후부 요도 판막증 1례

  • Kim, Sung-Hye (Department of Pediatrics, College of Medicine, University of Sungkyunkwan) ;
  • Shim, Jae-Won (Department of Pediatrics, College of Medicine, University of Sungkyunkwan) ;
  • Chang, Yun-Shil (Department of Pediatrics, College of Medicine, University of Sungkyunkwan) ;
  • Yang, Soon-Ha (Department of Obstetrics and Gynecology, College of Medicine, University of Sungkyunkwan) ;
  • Park, Kwan-Hyeun (Department of Urology, College of Medicine, University of Sungkyunkwan) ;
  • Jin, Dong-Kyu (Department of Pediatrics, College of Medicine, University of Sungkyunkwan) ;
  • Park, Won-Soon (Department of Pediatrics, College of Medicine, University of Sungkyunkwan)
  • 김성혜 (성균관대학교 의과대학 소아과학교실) ;
  • 심재원 (성균관대학교 의과대학 소아과학교실) ;
  • 장윤실 (성균관대학교 의과대학 소아과학교실) ;
  • 양순하 (성균관대학교 의과대학 산부인과학교실) ;
  • 박관현 (성균관대학교 의과대학 비뇨기과학교실) ;
  • 진동규 (성균관대학교 의과대학 소아과학교실) ;
  • 박원순 (성균관대학교 의과대학 소아과학교실)
  • Received : 2002.03.15
  • Accepted : 2002.05.14
  • Published : 2002.08.15
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Abstract

We present a case of in-utero vesicoamniotic shunting and postnatal vesicostomy in a very low birth weight baby with posterior urethral valve syndrome. He was diagnosed as posterior urethral valve at $24^{+5$ weeks' gestation. Because of severe hydronephrosis and oligohydroamnios, the shunt was established by basket-shaped catheter at $27^{+0}$ weeks' gestation. After shunt, hydronephrosis improved. At $29^{+4}$ weeks' gestation, the shunt catheter escaped from its position and severe urinary ascites and hydronephrosis developed. At 30 weeks' gestation, the baby was born and showed elevated BUN and creatinine. On the 10th day of birth, vesicostomy was done for urinary drainage. Thereafter, the baby has been followed up for 10 months and has had recurrent episodes of urinary infection. We report the case with a brief review of literature.

본 저자들은 산전에 후부 요도 판막증을 진단 받고 태아기 중재술로 임신기간을 1달간 유지하여 출생한 후 호흡기 합병증을 보였으나 극복하였고 방광 조루술을 통해 신기능을 유지하여 판막 제거술을 기다리고 있는 극소 저출생 체중아 1례를 경험하였기에 보고하는 바이다.

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