Iatrogenic Rupture of the Urinary Bladder in an Infant During Retrograde Cystourethrography

Area of Science:

• Pediatric Radiology
• Urology
• Surgical Pediatrics

Background:

• Retrograde cystourethrography is a common diagnostic procedure for pediatric urinary tract abnormalities.
• Iatrogenic bladder rupture is an exceedingly rare complication, particularly in infants.
• Adherence to established procedural guidelines is crucial for patient safety.

Observation:

• A 9-month-old infant developed an acute abdomen with signs of urinary peritonitis following retrograde cystourethrography.
• The patient presented 6 hours post-procedure with symptoms indicative of intraperitoneal bladder rupture.
• An urgent exploratory laparotomy was required for diagnosis and management.

Findings:

• The case confirmed iatrogenic intraperitoneal bladder rupture as the cause of the acute abdomen.
• Surgical repair of the bladder perforation was successfully performed in two layers.
• The infant experienced an unremarkable recovery and follow-up post-intervention.

Implications:

• This case underscores the critical importance of meticulous technique and adherence to retrograde cystourethrography protocols in pediatric patients.
• Radiologists and pediatric surgeons must be vigilant for rare complications, even with standard procedures.
• Reinforcing procedural safety criteria can minimize the risk of iatrogenic injuries during diagnostic imaging in children.