A Pelvic Mass: Bladder Diverticulum with Haemorrhage in Ehlers-Danlos Patient

Abstract

We report on a case of haemorrhage in a large bladder diverticulum, impressing as a pelvic mass, in a patient with the Ehlers-Danlos syndrome. A review of the literature revealed 14 other cases of bladder diverticula and the Ehlers-Danlos Syndrome. Conservative treatment is first choice, unless complications occur.

Congenital Bladder Diverticula in Infants

“…However, if the diverticulum is situated so that the ureter opens at its rim, the ureterovesical junction may become incompetent as the diverticulum becomes distended leading to ureteral reflux [1, 2]. Although CBD may occur sporadically, they develop more commonly in children with disturbance of connective tissue formation (DCTF) such as Ehlers-Danlos [5, 6], Menkes [7, 8] and Elfin-Facies [9] syndromes. A total of 50 cases have been reported in the English literature [1, 2, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20].…”

“…Although CBD may occur sporadically, they develop more commonly in children with disturbance of connective tissue formation (DCTF) such as Ehlers-Danlos [5, 6], Menkes [7, 8] and Elfin-Facies [9] syndromes. A total of 50 cases have been reported in the English literature [1, 2, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. Only 21 cases were isolated CBD [1, 2, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]; however, 29 other cases were associated with DCTF [5, 6, 7, 8, 9].…”

“…A total of 50 cases have been reported in the English literature [1, 2, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. Only 21 cases were isolated CBD [1, 2, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]; however, 29 other cases were associated with DCTF [5, 6, 7, 8, 9]. CBD almost always occur in boys and most reported cases were under 2 years of age [1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20].…”

“…Only 21 cases were isolated CBD [1, 2, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]; however, 29 other cases were associated with DCTF [5, 6, 7, 8, 9]. CBD almost always occur in boys and most reported cases were under 2 years of age [1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. However, an adult patient with CBD has also been reported [21].…”

“…Association of other urinary tract pathologies are infrequent in those patients with isolated lesions. However, patients with DCTF were most commonly associated with other urologic pathologies [5, 6, 7, 8, 9]. …”