Iatrogenic bladder injury from port insertion during laparoscopic appendicectomy

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Laparoscopic appendicectomy is a common procedure for acute appendicitis.
• Suprapubic port insertion requires careful anatomical consideration to avoid visceral injury.

Observation:

• A patient developed oliguria, high drain output, and elevated drain fluid creatinine post-laparoscopic appendicectomy.
• Contrast-enhanced computed tomography urography revealed intraperitoneal contrast, suggesting a urinary tract injury.

Findings:

• Diagnostic laparoscopy confirmed a bladder injury caused by a drain inserted via the suprapubic port.
• The drain had traversed the urinary bladder, necessitating surgical repair.

Implications:

• This case underscores the risk of urinary bladder injury during suprapubic port placement in laparoscopic appendicectomy.
• Bladder decompression and lateral port insertion can minimize this complication.
• A high index of suspicion is crucial for diagnosing iatrogenic bladder injuries.