Sayedin Hani, Datta Soumendra, Keoghane Stephen
Urology, Warrington and Halton Teaching Hospitals NHS Foundation Trust, Warrington, GBR.
Urology, Colchester University Hospital NHS Foundation Trust, Colchester, GBR.
Cureus. 2021 Dec 2;13(12):e20096. doi: 10.7759/cureus.20096. eCollection 2021 Dec.
Urinary bladder is the most common urologic organ exposed to iatrogenic injury. The bladder trauma is classified into extra-peritoneal, intra-peritoneal, or combined trauma. Intra-peritoneal bladder injury is conventionally being treated with open surgical repair, mainly to explore the abdominal viscera for possible associated injuries and to insert peritoneal drain. One rare form of the iatrogenic bladder injury is catheter-related bladder injury which is very uncommon and only few cases were reported. It is mainly related to other associated medical conditions like cancer and chronic catheterization which might be causing subsequent bladder wall weakness. Therefore, it is important to collect more data about this rare type of bladder injury, particularly urethral catheterization which is one of the most common medical procedures. We present a 74-year-old male patient who developed acute kidney injury and was treated by urethral catheterization in the emergency department. The patient developed immediately severe abdominal pain. Non-contrast CT showed intra-peritoneal bladder perforation by the urethral catheter. The patient developed peritonitis and failed a trial of conservative management. Consequently, laparoscopic abdominal exploration and bladder repair was performed successfully.
膀胱是最常遭受医源性损伤的泌尿系统器官。膀胱创伤分为腹膜外、腹膜内或联合创伤。传统上，腹膜内膀胱损伤采用开放手术修复，主要是探查腹腔脏器是否存在可能的相关损伤，并插入腹腔引流管。医源性膀胱损伤的一种罕见形式是导管相关性膀胱损伤，这种情况非常少见，仅有少数病例报道。它主要与其他相关疾病如癌症和长期导尿有关，这些可能导致随后的膀胱壁薄弱。因此，收集更多关于这种罕见类型膀胱损伤的数据很重要，特别是尿道插管，这是最常见的医疗操作之一。我们报告一名74岁男性患者，在急诊科因急性肾损伤接受尿道插管治疗。患者立即出现严重腹痛。非增强CT显示尿道导管导致腹膜内膀胱穿孔。患者发生腹膜炎，保守治疗试验失败。因此，成功进行了腹腔镜腹部探查和膀胱修复。
