Laproscopy-associated urinary bladder injury: Case report

Background: Bladder injury is a rare complication of laparoscopic surgery, but it can have severe consequences. Therefore, timely and efficient management of such iatrogenic bladder injuries is important. The present case report describes the occurrence, diagnosis, and management of an iatrogenic bladder injury that was diagnosed after laparoscopic appendectomy. Case Report: a 17-year-old girl, presented to emergency department with lower abdominal pain shifted to right iliac fossa. After full investigation she was diagnosed as acute appendicitis. Then was taken to operating theatre and underwent laparoscopic appendectomy. Post-operative course was uneventful and she was discharged home in good condition. Patient presented again to the emergency department complaining of severe lower abdominal pain and peritoneal signs. After investagtions she was diagnosed to have bladder injury right below suprapubic trocar insertion site. Diagnoses of iatrogenic bladder injury was made and patient was treated accordingly. Conclusion: Iatrogenic injury to the bladder during laparascpic procedure is a known complication, especially when inserting a suprapubic trocar. It is important that during a procedure such as laparascopic appendectomy to decompress the urinary bladder prior to procedure. Insertion should always be under direct visualization. And to know alternative ports insertion site to avoid bladder injury. Intraoperative identification of bladder injury is critical to achieve best outcomes, but if injury was occult then patient can present delayed with non-specific symptoms. Once a diagnosis is reached then treatment will depend on size of defect and symptoms of the patient.