Perforation Of Urinary Bladder Research Articles

Intraperitoneal Urinary Bladder Perforation with Pneumoperitoneum in Association with Indwelling Foley Catheter Diagnosed in Emergency Department

BackgroundIndwelling 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). Case ReportAn 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. Why Should an Emergency Physician Be Aware of This?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.

Urinary Bladder Injury During Colonoscopy Without Colon Perforation.

We report a case of urinary bladder perforation during colonoscopy. A 67-year-old female, who had undergone a transabdominal hysterectomy for uterine myomas 15 years ago, visited the emergency department with complaint of abdominal pain after a screening colonoscopy. Laparoscopic examination revealed severe adhesion between the sigmoid colon and the urinary bladder. The urinary bladder wall was weakened, and several perforation sites were found. The surgery was converted to a laparotomy. After a thorough examination, we performed primary repair for the perforation sites, followed by an omentopexy.

Spontaneous Rupture of the Urinary Bladder - A Case Report and Review of Literature

Introduction: Spontaneous rupture of the urinary bladder [SRUB] is a rare event. Patients usually present with features of peritonitis and diagnosis is usually made at operation. There are several factors that can predispose patients to an event like this, but most commonly it includes a chronic increase in bladder wall pressure and chronic inflammatory states besides malignancy. Case Report: A 42 years old male came in emergency surgery department with pain in abdomen. Ultrasonography of abdomen was suggestive of peritonitis for which he underwent exploratory laparotomy and was found to have perforation of urinary bladder which was repaired. Patient recovered uneventfully. Conclusion: Rupture of urinary bladder must be included in the differential diagnosis of acute abdomen presenting with peritonitis. A high index of suspicion is essential in the presence of urinary symptoms. In the majority of cases, underlying bladder pathology has been identified, although idiopathic SRUB may occur.

Surgical Management of Complications with Peritoneal Dialysis.

This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. The areas discussed include early complications such as surgical wound hemorrhage, bleeding from the catheter, intestinal perforation and urinary bladder perforation, dialysate leakage through the wound, as well as late complications including catheter kinking or occlusion, retention of fluid in the peritoneal recess, hernias and hydrothorax, and encapsulating peritoneal sclerosis. We also briefly cover the surgical aspects of exit-site infection and peritonitis. An understanding by nephrologists of the role for surgical intervention in PD patients will improve their care and outcomes.

Retrospective analysis of the learning curve associated with laparoscopic ovariectomy in dogs and associated perioperative complication rates.

To assess the learning curve associated with laparoscopic ovariectomy (LOE) in 618 dogs and to report perioperative complication rates. Case series. Dogs (n = 618). Data retrieved from the medical records of bitches admitted for LOE over 42 months included date of surgery, breed, weight (kg), age (months), surgeon, suture material used, intraoperative complications and postoperative complications. Each LOE was defined as "successful" or "unsuccessful" by the absence or presence of an intraoperative complication and "failure" rate described using a CUSUM technique. Follow-up time ranged from 152 to 1,435 days (median, 737 days). Intraoperative complications occurred in 10 dogs (1.6%) and included: splenic laceration (6 dogs; 1%), urinary bladder perforation (3 dogs; 0.5%), and subcutaneous emphysema (1 dog; 0.2%). Postoperative complications occurred in 99 dogs (16%) and included: incisional inflammation treated with antibiotics (87 dogs [14%]; 96/1,854 incisions; 5.1%), incisional seroma (5 dogs [0.8%]; 5/1,854 incisions, 0.3%), incisional hernia (4 dogs [0.6%]; 4/1,854 incisions, 0.2%), and ovarian remnant syndrome (3 dogs; 0.5%). CUSUM charts indicated an initial "learning curve" of ∼80 LOE. LOE is a technique with an initial learning curve but once surgical proficiency is reached after ∼80 procedures then intraoperative complication rates associated with the procedure can be low.

Delayed spontaneous perforation of urinary bladder with intraperitoneal seeding following radical transurethral resection of invasive urothelial cancer: a case report

BackgroundTransurethral resection of bladder tumor (TURBT) may be applicable for the treatment of deeply invasive tumors in high-risk patients who are not suitable candidates for radical cystectomy. Intraperitoneal perforation is much less common, however, bladder wall perforation is still a cause for concerns because after perforation several studies have been reported to have peritoneal or abdominal metastases.Case presentationAn 84-year-old female patient with multiple large enhancing masses in the urinary bladder underwent radical TURBT to remove the deeply invasive tumors because she was not a suitable candidate for a major operation. Microscopic examination of the resected specimen confirmed the muscle invasive urothelial carcinoma with partial invasion into the perivesical fat tissue. She visited again 6 months later after the operation complaining abdominal distension. Computed tomography showed perforation of urinary bladder with intraperitoneal seeding and adnexa metastasis.ConclusionRadical TURBT could be associated with delayed perforation of urinary bladder and intraperitoneal seeding.

Urinary Bladder Perforation by Migratory Copper T: A Case Report

A migrated Copper T could go unnoticed or can present with symptoms, depending on the organ of migration. Urinary bladder perforation by an IUD is a very unusual presentation. Here, we report a case, where the patient presented with urinary symptoms, which on further evaluation, proved to be caused by a Copper T that had eroded into the Urinary Bladder.

Urinary bladder perforation due to encrusted cystitis: A rare entity

Encrusted cystitis is extremely rare and severe chronic infection of the bladder causing intolerable function and serious consequences for the patient. Herein, we report a new case of encrusted cystitis complicated by rupture of the bladder, septic peritonitis and uroperitoneum, and digestive fistula in a 57-year-old male and review literature. Encrusted cystitis is a severe entity that its evolution is unpredictable and it may be complicated by urinary bladder rupture that should be considered.

Perineal Bull Gore with Urinary Bladder Perforation and Pneumoperitoneum

Animal related injuries are frequently reported in India and other countries, where bulls are used for sporting events as well as in places where farming and livestock rearing is practised. The presentation is, many times, atypical and misleading as well. They have unique mechanics of injury. The patterns of the injury are reviewed. An intra-peritoneal urinary bladder injury which is caused by a perineal bull gore with a pneumoperitoneum is unusual and it has not been reported in the literature which was reviewed. We are reporting a successfully treated 25 years old male patient from the slopes of the southern district of Manipur, India, who had presented 40 hours after he was injured. The identification and prompt exploration, keeping in mind the mechanics of bull goring, helps the surgeons to adequately deal such atypical injuries, for optimal outcomes.

Spontaneous, idiopathic urinary bladder perforation – case report

Spontaneous, idiopathic urinary bladder rupture is a very rare disease entity, which may face the problem of proper preoperative diagnosis. In many cases the medical history, physical examination, and additional tests raise false suspicion of gastrointestinal perforation. The study presented a case of a female patient with spontaneous urinary bladder perforation, paying particular attention to the diagnostic difficulties associated with the above-mentioned pathology. The aim of the study was to analyse the presence of symptoms and imaging and laboratory results observed in case of spontaneous urinary bladder rupture, as well as differentiate the above-mentioned pathology with gastrointestinal perforation. Whenever diagnosing a patient with acute peritonitis symptoms, in whom the predominating symptoms include sudden abdominal pain, peritoneal cavity fluid presence, hematuria, oliguria, and coexisting increased urea, creatinine, and potassium levels, one should consider the possibility of urinary bladder rupture.

Intraperitoneal Urinary Bladder Perforation Observed in a Patient with an Indwelling Urethral Catheter

This report describes a rare case of an 86-year-old man with an indwelling urethral catheter who developed severe abdominal pain and was diagnosed with intraperitoneal urinary bladder perforation. A home-visiting nurse suspected catheter obstruction and performed a catheter exchange. However, bladder irrigation could not subsequently be performed. Computed tomography of the abdomen and pelvis after transurethral perfusion of contrast medium demonstrated extravasation of the contrast material into the peritoneal cavity. Furthermore, the Foley catheter balloon was positioned in the peritoneal cavity through the bladder. The patient was diagnosed with peritonitis due to spontaneous intraperitoneal perforation of the urinary bladder, and exploratory laparotomy was performed. During exploration, a perforated tear at the top of the bladder was discovered where the Foley catheter had penetrated the bladder. The Foley catheter balloon was floating freely in the peritoneal cavity. There was no evidence of pathologic lesions, such as cancer or inflammatory mass at the site of the injured peritoneum. Successful closure of the damaged peritoneum and bladder was performed. Since the proportion of elderly individuals continues to increase in the general Japanese population, the incidence of the chronic Foley catheterization is expected to increase. Therefore, clinicians should be aware of this potential complication.

Urinary bladder perforation, intra-corporeal knotting, and per-urethral extrusion of ventriculoperitoneal shunt in a single patient: case report and review of literature

Ventriculoperitoneal shunt (VPS) surgery is the most common procedure performed for the treatment of hydrocephalus. Erosive bladder perforation by a peritoneal catheter is an extremely rare complication of VPS. Only ten cases involving the normal (non-augmented) urinary bladder have been reported so far. We report a case of erosive bladder perforation, intra-corporeal knot formation, and perurethral extrusion of the distal end of VPS. This is the second only case report so far in the world literature showing triad of uncommon VPS complications in a single patient. Prompt management could avoid further complications. Patient's parents should be aware about this rare complication, so that they can seek timely medical help.

An unusual cause of death: spontaneous urinary bladder perforation

Spontaneous urinary bladder perforation is a rare and life-threatening condition similar to traumatic and iatrogenic perforation. The connection with the underlying bladder damage due to previous radiotherapy, inflammation, malignancy, obstruction, or other causes can be found in almost all cases. The symptoms are often nonspecific, and misdiagnosis is common. Here, we present a case of spontaneous urinary bladder perforation due to bladder necrosis in a diabetic woman. She presented to the emergency department with abdominal pain. Exploratory laparotomy was performed by surgeons and revealed necrosis of the anterior and lateral walls of the urinary bladder. Microscopic examination revealed necrotic changes throughout the bladder wall. Ghost-like cellular outlines were compatible with coagulative necrosis. Clusters of bacteria were also present in some necrobiotic tissues. Malignant cells were not present. It appears probable that the infection was due to local interference with the blood supply (arterial, capillary, or venous) combined with the systemic metabolic upset that led to the bladder condition. In our case, we observed partial necrosis of the bladder rather than distortion of the entire blood supply to the bladder as consequences of the microvascular effects of diabetes. Urinary bladder perforation must be considered in the differential diagnosis of patients presenting with free fluid in the abdomen/peritonitis, decreased urine output, and hematuria, and in whom increased levels of urea/creatinine are detected in serum and/ or peritoneal fluid aspirate.

Emphysematous Cystitis Complicated by Urinary Bladder Perforation: A Case Report

Emphysematous cystitis is a rare serious complication of urinary tract infection characterised by gas formation in the wall or lumen of the urinary bladder due to bacterial fermentation. We report a case of an 86-year-old female with emphysematous cystitis complicated by anterior bladder wall perforation. Her urine grew Escherichia coli and imaging showed gas collection inside the urinary bladder and outside the ruptured anterior bladder wall. She was treated with antibiotics and bladder irrigation and responded well without surgery. Early diagnosis and treatment improve the outcome, hence the importance of a high index of suspicion.

Asymptomatic perforation of large bowel and urinary bladder as a complication of ventriculoperitoneal shunt: Report of two cases

Insertion of a ventriculoperitoneal (VP) shunt, the method of choice in the treatment of hydrocephalus, is often followed by various mechanical and/or infective complications. We present two children with asymptomatic perforation of the large bowel and urinary bladder, relatively rare and potentially severe complications of this surgical procedure. In both patients a VP shunt was implanted in the first month after birth; in a boy due to congenital hydrocephalus and in a girl due to the consequences of intracranial haemorrhage. Immediately after surgery, as well as during the further course, in both children growth and development were optimal and without any signs of infection or VP shunt malfunction. In the boy at age 6 months and in the girl at age 4 years, without any signs of complications, mothers noted the prominence of the VP shunt tip from the anus in the first case and from the urethral orifice in the second one. The VP shunts were immediately changed, so that both complications were resolved without any consequences. Insertion of a VP shunt represents the most frequent method of choice of the surgical treatment of hydrocephalus, but also potentially a highly risky procedure followed by various complications about which parents should be informed when patients are children. Owing to adequate approach in the follow-up of children with implanted VP shunt, large bowel and urinary bladder perforation, examples of severe and potentially fatal complications of this surgical intervention, could be disclosed on time and adequately resolved.

Over 500 obturator nerve blocks in the lithotomy position during transurethral resection of bladder tumor

Introduction and aim of the studySpinal anesthesia for transurethral resection of bladder tumor (TURB) does not prevent unintended stimulation of the obturator nerve when electroresection is performed on the lateral wall of the bladder. It results in muscle contraction of the adductor muscles of the thigh, which may lead to perforation of bladder wall with the resectoscope loop. The aim of the study was to assess the efficacy and safety of obturator nerve block (ONB).MethodsThis prospective study was conducted between 01/01/1999 and 12/31/2010 in the Department of General, Oncologic and Functional Urology, Medical University of Warsaw. In 431 patients undergoing TURB adductor spasms were observed. In these cases nerve stimulation and ONB with 2% lidocaine using thigh interadductor approach in the lithotomy position were performed.ResultsThe efficacy of 542 ONB was 94%. In 31 cases general anesthesia was necessary. There were two cases of urinary bladder perforation, but only one resulted from an insufficient nerve block. Both were managed conservatively. Neither hematomas nor neurological adverse events were observed.ConclusionThe described method offers a high rate of efficacy and ensures optimal and safe conditions for the resection of a tumor located on the inferolateral wall of the urinary bladder. The risk of complication is low.

Extraperitoneal Urinary Bladder Perforation Detected by FDG PET/CT

Accurate localization of areas of increased metabolic activity on PET only imaging can be challenging. Fusion of PET with CT imaging provides anatomic detail which aids in localization of functional information. As a result, the overall sensitivity and specificity of information provided by PET or CT alone is improved with combined PET/CT resulting in improved diagnosis and patient management. We report a case of an unexpected emergent finding of urinary bladder perforation on PET/CT to stress the importance of accurately interpreting the anatomic and functional data. To our knowledge, diagnosis of bladder perforation on PET/CT has not been previously reported in the literature. Failure to recognize such complications may lead to adverse outcomes.

Perforation of the Native Urinary Bladder as a Complication of Intermittent Self Catheterisation

Perforation of the Native Urinary Bladder as a Complication of Intermittent Self Catheterisation

Spontaneous Perforation of Urinary Bladder Secondary to Candida Cystitis: Acute Abdomen of Urologic Origin

Spontaneous urinary bladder perforation is a rare event; presentation as an acute abdomen is rarer still. Fungal cystitis has seldom, and Candida albicans cystitis has never, to our knowledge, been reported as a cause of perforation. Case report and literature review. A 70-year-old woman with diabetes mellitus presented with an acute abdomen and urinary symptoms. A diagnosis of an intraperitoneal bladder perforation was made during emergency operation; culture of the peritoneal fluid and urine yielded Candida albicans. The initial high blood urea nitrogen and serum creatinine concentrations mimicked acute renal failure but were caused by urine absorption across the peritoneum. The patient was treated successfully with emergency laparotomy, a three-week course of fluconazole, and a five-day course of bladder irrigation with amphotericin B. Spontaneous urinary bladder perforation secondary to Candida cystitis should be considered as a possible cause of acute abdomen, especially when the biochemical profile suggests urine absorption and yeast is reported in the urinalysis of an immunocompromised patient.

Intestinal obstruction: a rare complication of channeling Transurethral Resection of the Prostate (TURP): a case report

IntroductionChanneling transurethral resection of the prostate is a recognized form of adjunctive treatment in the treatment of patients with prostate cancer. Despite the fact that complications arising from the procedure have been on the decline, rare complications like intestinal obstruction may occur.Case presentationThis is a case report of a 56 year old man who developed mechanical intestinal obstruction few days after a channeling TURP for advanced CaP.ConclusionThe report highlights the possibility of intestinal obstruction as a secondary event following a silent urinary bladder perforation during channeling TURP. Early recognition and intervention were responsible for the good outcome in this patient.