Cargando…

Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report

INTRODUCTION: Bladder injury is an uncommon complication of cesarean delivery (CD) with an incidence ranging from 0.0016% to 0.94%. The risk factors are emergency CDs, subsequent CDs, trial of normal delivery after CD and whether adhesions are present or not. The presentation is either immediate int...

Descripción completa

Detalles Bibliográficos
Autores principales: Aghaways, Ismaeel, Bapir, Rawa, Hawrami, Tahir A., Thahir, Nishtman M., Al Kadum Hassan, Mohammed Abed, Salih Hassan, Karzan Mohammed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525288/
https://www.ncbi.nlm.nih.gov/pubmed/31102837
http://dx.doi.org/10.1016/j.ijscr.2019.04.050
_version_ 1783419696927735808
author Aghaways, Ismaeel
Bapir, Rawa
Hawrami, Tahir A.
Thahir, Nishtman M.
Al Kadum Hassan, Mohammed Abed
Salih Hassan, Karzan Mohammed
author_facet Aghaways, Ismaeel
Bapir, Rawa
Hawrami, Tahir A.
Thahir, Nishtman M.
Al Kadum Hassan, Mohammed Abed
Salih Hassan, Karzan Mohammed
author_sort Aghaways, Ismaeel
collection PubMed
description INTRODUCTION: Bladder injury is an uncommon complication of cesarean delivery (CD) with an incidence ranging from 0.0016% to 0.94%. The risk factors are emergency CDs, subsequent CDs, trial of normal delivery after CD and whether adhesions are present or not. The presentation is either immediate intraoperative event or delayed bladder rupture and urinary ascites. CASE PRESENTATION: A 35-year-old female presented with considerable abdominal distension, shortness of breath, oliguria, straining to void and elevated levels of blood urea and serum creatinine 11 days after an uneventful Caesarean delivery. Abdominal ultrasound showed marked ascites. Immediate resuscitation was done, a urethral catheter and percutaneous intraperitoneal pigtail catheter were inserted confirming urinary ascites. Next day cystoscopy was performed and revealed a perforation at the posterior wall of the bladder. She was kept on conservative treatment with adequate urine diversion through both urethral and intraperitoneal catheter. Her condition improved and responded well. DISCUSSION: To the best of our knowledge this presentation of delayed intraperitoneal bladder rupture post CD is the second case reported in literature. Although surgical repair is regarded as the treatment of choice for intraperitoneal bladder injury, conservative treatment may succeed in properly selected cases. Non-operative managements include indwelling transurethral Foley catheter alone, percutaneous peritoneal drain alone or combined Foley catheter and percutaneous peritoneal drain for complete urinary drainage. CONCLUSION: Delayed urinary bladder rupture is a very rare complication of cesarean delivery. Non-operative treatment can be a viable alternative to surgical repair in carefully selected patients.
format Online
Article
Text
id pubmed-6525288
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-65252882019-05-28 Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report Aghaways, Ismaeel Bapir, Rawa Hawrami, Tahir A. Thahir, Nishtman M. Al Kadum Hassan, Mohammed Abed Salih Hassan, Karzan Mohammed Int J Surg Case Rep Article INTRODUCTION: Bladder injury is an uncommon complication of cesarean delivery (CD) with an incidence ranging from 0.0016% to 0.94%. The risk factors are emergency CDs, subsequent CDs, trial of normal delivery after CD and whether adhesions are present or not. The presentation is either immediate intraoperative event or delayed bladder rupture and urinary ascites. CASE PRESENTATION: A 35-year-old female presented with considerable abdominal distension, shortness of breath, oliguria, straining to void and elevated levels of blood urea and serum creatinine 11 days after an uneventful Caesarean delivery. Abdominal ultrasound showed marked ascites. Immediate resuscitation was done, a urethral catheter and percutaneous intraperitoneal pigtail catheter were inserted confirming urinary ascites. Next day cystoscopy was performed and revealed a perforation at the posterior wall of the bladder. She was kept on conservative treatment with adequate urine diversion through both urethral and intraperitoneal catheter. Her condition improved and responded well. DISCUSSION: To the best of our knowledge this presentation of delayed intraperitoneal bladder rupture post CD is the second case reported in literature. Although surgical repair is regarded as the treatment of choice for intraperitoneal bladder injury, conservative treatment may succeed in properly selected cases. Non-operative managements include indwelling transurethral Foley catheter alone, percutaneous peritoneal drain alone or combined Foley catheter and percutaneous peritoneal drain for complete urinary drainage. CONCLUSION: Delayed urinary bladder rupture is a very rare complication of cesarean delivery. Non-operative treatment can be a viable alternative to surgical repair in carefully selected patients. Elsevier 2019-05-10 /pmc/articles/PMC6525288/ /pubmed/31102837 http://dx.doi.org/10.1016/j.ijscr.2019.04.050 Text en © 2019 The Author(s) http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aghaways, Ismaeel
Bapir, Rawa
Hawrami, Tahir A.
Thahir, Nishtman M.
Al Kadum Hassan, Mohammed Abed
Salih Hassan, Karzan Mohammed
Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title_full Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title_fullStr Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title_full_unstemmed Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title_short Conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: A case report
title_sort conservative management of delayed presentation of intraperitoneal bladder rupture following caesarean delivery: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525288/
https://www.ncbi.nlm.nih.gov/pubmed/31102837
http://dx.doi.org/10.1016/j.ijscr.2019.04.050
work_keys_str_mv AT aghawaysismaeel conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport
AT bapirrawa conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport
AT hawramitahira conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport
AT thahirnishtmanm conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport
AT alkadumhassanmohammedabed conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport
AT salihhassankarzanmohammed conservativemanagementofdelayedpresentationofintraperitonealbladderrupturefollowingcaesareandeliveryacasereport