Conservative treatment of an intraperitoneal bladder perforation

Abstract

IntroductionThe management of bladder rupture depends on its anatomical location.Material and methodsCase report and review of the pertinent English language literature.ResultsA 56-year-old man with history of an anterior rectum resection with partial cystectomy presented with signs of acute renal failure, and later with a tender, distended abdomen. Work-up including serum and ascites biochemistry, cystoscopy, and CT cystography diagnosed urinary ascites. The small intraperitoneal bladder rupture was treated conservatively via continued urinary drainage under urinary antibiotic prophylaxis until closure.ConclusionA conservative treatment of a small intraperitoneal bladder perforation is possible under certain conditions.

Successful Tenckhoff catheter salvage in a patient with peritoneovesical fistula: A case report

“…Extraperitoneal ruptures (EPR) are generally managed conservatively, while intraperitoneal ruptures (IPR) are usually treated surgically. However, there is increasing evidence on conservative management of IPR in the absence of associated injuries or large perforations and sepsis and maintaining continuous bladder drainage [10, 11]. In our case, it could have been an IPR in view of the final position in the peritoneal cavity after the catheter had been pulled back.…”

An Interesting Complication After the Transurethral Bladder Tumor Resection: Inflated Catheter Balloon Out of the Bladder

“…Although there are those who support emergency laparotomy in the treatment of the bladder perforation, there are also authors who support that the conservative treatment must be applied primarily. 5,15 While especially retroperitoneal perforations are mostly treated conservatively, a surgical operation is mostly needed in intraperitoneal perforations. 1,6 Moreover, there are those who prefer the conservative approach in the intraperitoneal perforation.…”

Spontaneous rupture of the bladder during vomiting

“…For intraperitoneal injuries, the standard of care is surgical exploration with repair. However, if the perforation is small and the patient has multiple comorbidities and is not fit for general anaesthetic, a conservative approach with antibiotics and abdominal drain and a catheter may be considered 19. If the rupture is extraperitoneal, management is usually conservative with antibiotics and a urinary catheter maintaining a low-pressure bladder on free drainage.…”