Rickets Secondary to Chronic Hyperchloremic Acidosis in Ureterosigmoidostomy

Abstract

Hyperchloremic acidosis as a complication of ureterosigmoidostomy has been recognized for many years.¹ The occurrence of additional electrolyte changes of serum calcium and phosphorus compatible with the presence of osteomalacia has also been noted.² However, to our knowledge the development of juvenile rickets secondary to hyperchloremic acidosis has not been reported previously. The presence of this syndrome in a juvenile patient who had undergone bilateral ureterosigmoidostomy represents an unusual case and is of particular interest because of the dramatic improvement which occurred clinically and radiologically after therapy. Report of Case A 14-year-old white boy was admitted to the Community Memorial Hospital because of weakness, anorexia, headache, and pain in the knees on walking. He had been born with exstrophy of the bladder, and his history revealed the following types of treatment of this anomaly and its postoperative complications. In 1946, at the age of 4 years, bilateral ureterocolostomy