Iatrogenic Bladder Rupture Research Articles

326 Unprecedented Complications: First-Ever Case Report of Undetected Iatrogenic Bladder Rupture Presenting as Osteomyelitis of the Pubis and Fournier’s Gangrene

326 Unprecedented Complications: First-Ever Case Report of Undetected Iatrogenic Bladder Rupture Presenting as Osteomyelitis of the Pubis and Fournier’s Gangrene

Conservative management of iatrogenic bladder rupture and uroperitoneum in a gelding with urolithiasis

SummaryThis report details a case of iatrogenic bladder rupture in a gelding that was successfully treated with conservative management. Rupture occurred at the time of attempted cystoscopy, whilst the bladder was being insufflated with air for further investigation of stranguria and suspected urolithiasis. The gelding was treated with temporary perineal urethrostomy, peritoneal lavage and drainage of urine from the bladder and made a complete recovery.

Extravasation of the Contrast Material During Voiding Cystourethrography in a Chronic Spinal Cord Injury Patient: A Case Report.

Neurogenic bladder is common in most spinal cord injury patients. Voiding cystourethrography (VCUG) is recommended in these patients to detect urinary tract complications. However, rare but serious complications may occur during VCUG, although VCUG is generally safe. There are several case reports of bladder rupture occurring in pediatric patients. Here, we report the first case of iatrogenic bladder rupture in an adult spinal cord injury patient in Korea. Particularly, extravasation of contrast without manual instillation has hardly ever been reported. To the best of our knowledge, this is the first reported case of bladder rupture without manual instillation during VCUG. We report a case of a 59-year-old female with paraplegia due to tuberculous spondylitis who underwent VCUG as a part of routine evaluation of neurogenic bladder. Extravasation of the contrast media during VCUG developed as a complication and the patient recovered spontaneously without any intervention. Therefore, VCUG should be performed properly in chronic spinal cord injury patients.

Iatrogenic Bladder Rupture in a Child Following Voiding Cystourethrography and Its Laparoscopic Management

Iatrogenic Bladder Rupture in a Child Following Voiding Cystourethrography and Its Laparoscopic Management

Iatrogenic Bladder Rupture Presenting with Diffuse Subcutaneous Emphysema

Iatrogenic bladder rupture is not an uncommon complication, especially during transurethral endoscopic procedures. Gross hematuria is the most frequent indication, along with lower abdominal pain and inability to void. However, subcutaneous emphysema is a rare sign of bladder perforation and can lead to misdiagnosis, especially when associated with acute abdomen. Here, we describe an uncommon case of iatrogenic bladder perforation presenting with pneumoperitoneum and diffuse subcutaneous emphysema. The patient underwent urethrocystoscopy and cystoscopic evacuation of blood clots after which abdominal pain was present. A computed tomography (CT) scan revealed diffuse subcutaneous emphysema in the abdomen, chest, and neck as well as pneumoperitoneum, but no pneumothorax or intraperitoneal fluid accumulation was identified. Intraperitoneal bladder perforation was confirmed by diagnostic laparoscopy, and open repair was performed. The patient recovered well after surgical repair, and the subcutaneous emphysema resolved a few days latter.

A Report of an Iatrogenic Bladder Rupture in a Normal Healthy Child During Voiding Cystourethrography

Iatrogenic and spontaneous bladder disruption in healthy children during a voiding cystourethrography is very uncommon. We present a case of iatrogenic extraperitoneal bladder rupture in a healthy normal child during the filling phase of a voiding cystourethrography performed by a pediatric radiologist, using routine gravity technique. This injury completely healed after 48 hours of catheter drainage with observation and was confirmed with a normal voiding cystourethrogram. The patient's underlying disease, age, proper catheter placement, and appropriate speed and volume of the contrast instilled are important factors to prevent this very uncommon event in this very common radiologic test.

An unusual cause of iatrogenic bladder rupture

Indwelling Foley catheter is a rare cause of urinary bladder perforation, a serious injury with high mortality that demands accurate and prompt diagnosis. While the gold standard for diagnosis of bladder injury is computed tomography (CT) cystography, few bladder ruptures associated with Foley catheter have been reported to be diagnosed in the emergency department (ED).An 83-year-old man with indwelling Foley catheter presented to the ED for hematuria and altered mental status. He was diagnosed to have intraperitoneal rupture of the urinary bladder in the ED using abdominal and pelvic CT without contrast, which demonstrated bladder wall discontinuity, intraperitoneal free fluid, and pneumoperitoneum. The patient was treated successfully with medical management and bladder drainage.To our knowledge, this is the first report of intraperitoneal urinary bladder perforation associated with Foley catheter diagnosed in the ED by CT without contrast. Pneumoperitoneum found in this case was a clue to the diagnosis and is a benign finding that does not necessitate urgent surgical intervention. The early and accurate diagnosis in this case allowed for effective management with good clinical outcome. The use of indwelling Foley catheter has a high prevalence, especially in long-term care facility residents, who are frequent visitors in the ED. Therefore, emergency physicians and radiologists should be familiar with the presentation and imaging findings of this potential injury associated with Foley catheters.