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Occult bladder injury after laparoscopic appendicectomy

Meher Lad1, Sarah Duncan, Darren K Patten

  • 1Department of General Surgery, North Middlesex Hospital, London, UK.

BMJ Case Reports
|November 26, 2013
PubMed

Insights

A rare complication of laparoscopic appendicectomy, intraperitoneal bladder perforation, occurred in a patient. This highlights the need for meticulous surgical preparation and careful instrument handling to prevent serious patient outcomes.

Area of Science:

  • Minimally invasive surgery
  • Surgical complications
  • Laparoscopic surgery

Background:

  • Minimally invasive procedures offer benefits like reduced pain and shorter hospital stays.
  • Laparoscopic surgery requires extensive training and meticulous preparation.
  • Preventing complications is crucial in all surgical procedures.

Observation:

  • A 35-year-old patient developed redness, swelling, and oliguria two days post-laparoscopic appendicectomy for a perforated appendix.
  • Delayed CT scan revealed contrast leakage around the bladder into the peritoneal cavity.
  • This indicated an intraperitoneal bladder perforation, a rare surgical complication.

Findings:

  • The patient underwent urinary catheterization for six days.
  • A follow-up CT cystogram confirmed the absence of leakage into the peritoneal cavity.
  • This case demonstrates a rare but serious complication following laparoscopic appendicectomy.

Implications:

  • Thorough pre-operative preparation is essential in laparoscopic surgery.
  • Careful instrument manipulation during routine procedures can minimize risks.
  • Awareness of rare complications like intraperitoneal bladder perforation is vital for surgical teams.

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