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Kefalas C, Menni A, Karlafti E, Panidis S, Chatziantoniou G, Katsiafliaka K, Krokou D, Ioannidis A, Goulas P, Netta S, Paramythiotis D. Uroperitoneum as a Complication of Laparoscopic Cholecystectomy: A Case Report. J Pers Med 2023; 13:jpm13040696. [PMID: 37109082 PMCID: PMC10146831 DOI: 10.3390/jpm13040696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Bladder rupture is more frequently encountered in blunt pelvic trauma, but can also be spontaneous or iatrogenic. Laparoscopic repair has been widely used during the last few years as a treatment for intraperitoneal bladder perforation. The bladder is the genitourinary organ most often affected by iatrogenic injury. The purpose of this article is to report what is, to our knowledge, the first documented case of bladder rupture as a complication of laparoscopic cholecystectomy. CASE DESCRIPTION A 51-year-old female presented to the emergency department complaining about generalized abdominal pain on the sixth postoperative day after laparoscopic cholecystectomy. Laboratory results highlighted a significant impact on renal function while the abdominal CT scan demonstrated free intraperitoneal fluid collection and surgical clips in the anatomic region of the liver and in an ectopic position near the ileocecal valve. An explorative laparoscopy revealed a 2 cm defect in the superior bladder wall, which was repaired in one layer in a continuous-locking fashion. The patient was discharged home on the fifth postoperative day having an uneventful recovery. CONCLUSION Bladder rupture frequently presents with non-specific clinical signs; as a result, it is easily misdiagnosed, especially when it occurs with a non-typical mechanism of injury. Pseudorenal failure is a relatively obscure entity that may help the clinician suspect a bladder perforation. Laparoscopic repair with a single-layer continuous suture technique is a safe and feasible treatment in hemodynamically stable patients. Prospective research is required to specify the optimal timing of catheter removal after bladder repair.
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Affiliation(s)
- Charalampos Kefalas
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Alexandra Menni
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Eleni Karlafti
- Emergency Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Stavros Panidis
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Georgios Chatziantoniou
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Konstantina Katsiafliaka
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Despina Krokou
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Aristeidis Ioannidis
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Patroklos Goulas
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Smaro Netta
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
| | - Daniel Paramythiotis
- 1st Propaedeutic Surgery Department, AHEPA University General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece
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