Acute abdomen due to a foreign body in the urinary bladder in an adolescent

A foreign body in the urinary bladder can cause an acute abdomen in an adolescent.

A 14-year-old girl presented to the emergency department with severe suprapubic pain, dysuria, hematuria, and hypovolemic shock. An ultrasound examination revealed liquid in the abdomen. An X-ray study of the abdomen revealed an 8-cm-long metallic object located in the urinary bladder. The patient underwent an emergent laparotomy with the diagnosis of acute abdomen. At laparotomy, approximately 2000 cc of widely dispersed serohemorrhagic fluid was removed. Clearing of the abdomen exposed a nail; it had perforated the bladder and 5 cm of it was in the abdominal cavity. A vertical incision was made to the urinary bladder. A 10-penny caliber, 8.2-cm-long steel nail was gently removed and the perforation was closed primarily. The outcome was uneventful and the patient was discharged from the hospital on the seventh postoperative day.

A foreign body can cause severe problems and should be kept in mind in the differential diagnosis of acute abdomen in an adolescent.