Robert L. Lebowitz, M.D. Children' s Hospital, Harvard Medical School Boston, Massachusetts

This 6-year-old girl came from Greece. SHe was born with exstrophy of the bladder and had undergone turn-in of her extrophied bladder. On arrival here, she had pain in her pelvis and hematuria. She dribbled urine constantly and was not on intermittent catheterization. Ultrasonography showed a shadowing focus in the bladder (fig 1), a large stone, and this was confirmed on a film of the pelvis that showed the wide separation of the pubic bones, typical for exstrophy, and a large stone, measuring 2-3 cm. in diameter, within the bladder (fig 2, arrow) The stone was to be removed through a cystotomy, under general anesthesia.

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