A report of an iatrogenic bladder rupture in a normal healthy child during voiding cystourethrography

Area of Science:

• Pediatric Radiology
• Urology
• Medical Imaging

Background:

• Voiding cystourethrography (VCUG) is a common diagnostic imaging test in pediatric urology.
• Bladder disruption, both iatrogenic and spontaneous, is an exceedingly rare complication during VCUG in healthy children.
• Understanding risk factors is crucial for preventing iatrogenic injuries during this procedure.

Observation:

• A case of iatrogenic extraperitoneal bladder rupture occurred in a healthy child during the contrast filling phase of a VCUG.
• The procedure was performed by a pediatric radiologist utilizing a standard gravity-based technique.
• The injury was noted during the filling phase, prior to voiding.

Findings:

• The iatrogenic bladder rupture in this healthy child completely healed within 48 hours.
• Treatment involved simple catheter drainage and clinical observation.
• A follow-up voiding cystourethrogram confirmed complete resolution of the injury.

Implications:

• Careful attention to patient factors (age, underlying conditions) and procedural technique (catheter placement, contrast instillation rate and volume) is vital.
• This case underscores the importance of meticulous technique in preventing rare complications during routine pediatric imaging.
• Prompt recognition and conservative management, such as catheter drainage, can effectively treat iatrogenic bladder injuries.