Large bladder stone in a young child, a rare case report

Background Bladder stone in children is a rare disease accounting for 5% of all urinary calculi and relatively more common in middle and low-income countries due to nutritional factors, poor water sanitation and warm climates. Case Presentation We present a case of large bladder stone to a 1 year and 6 months old male toddler from Afar region of Ethiopia presented with urinary frequency, urgency, dysuria and intermittent low grade fever of 5 months duration. He also cries and pulls his penis down. Otherwise, he has no remarkable medical or surgical history. At presentation, his abdomen was flat with mild suprapubic tenderness. Microscopic examination of urine shows multiple calcium oxalate crystals. Abdominal ultrasound shows about 30*24*17 millimeters sized hyperechoic, mobile mass with acoustic shadow within the urinary bladder. KUB x ray was taken and shows radiopaque elliptical body in the pelvis. Open cystolithotomy was done and about 28*22*13 millimeters sized, elliptical, hard bladder stone was removed and sent for analysis suggestive of calcium oxalate stone. On follow up till 6 months, the child had none of the possible complications nor recurrence. Clinical discussion Primary bladder calculi are most common in children younger than 10 years old, with a peak incidence at 2 to 4 years. Most of the case reports at these ages shows stone size less than 25 millimeters. Our case reported here is very young (1 year and 6 months) and the stone removed from him is large (28 millimeters). Conclusion Clinicians working in endemic areas should be at high index of suspicion and avoid delayed diagnosis of bladder stones for children with frequent urinary complaints at their initial visit.