scholarly journals Delayed Diagnosis of Iatrogenic Bladder Perforation in a Neonate

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Antoinette S. Birs ◽  
Jose A. Perez ◽  
Mark A. Rich ◽  
Hubert S. Swana
Keyword(s):  
Umbilical Artery ◽  
Delayed Diagnosis ◽  
Abdominal Distension ◽  
Diagnostic Tools ◽  
Bladder Injury ◽  
Voiding Cystourethrogram ◽  
Hypoxic Conditions ◽  
Bladder Injuries ◽  
Vein Catheterization ◽  
Urinary Peritonitis

Iatrogenic bladder injuries have been reported in the neonate during umbilical artery/vein catheterization, voiding cystourethrogram, urinary catheterizations, and overwhelming hypoxic conditions. Patients with iatrogenic bladder perforations can present with acute abdomen indicating urinary peritonitis, septic-uremic shock, or subtle symptoms like abdominal distension, pain, hematuria, uremia, electrolyte imbalances, and/or difficulty urinating. The following neonatal case report of perforated bladder includes a review of the signs, symptoms, diagnostic tools, and management of bladder injury in neonates.

scholarly journals Pseudo-renal Failure following the Delayed Diagnosis of Bladder Perforation after Diagnostic Laparoscopy

2003 ◽  
Vol 31 (2) ◽  
pp. 211-213 ◽  
Author(s):  
P. S. Kruger ◽  
R. S. Whiteside
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Diagnostic Laparoscopy ◽  
Delayed Diagnosis ◽  
Young Female ◽  
Bladder Perforation ◽  
Bladder Injury ◽  
Biochemical Features ◽  
Urinary Peritonitis ◽  
Biochemical Abnormalities

We present a case of bladder injury as a complication of gynaecological laparoscopic surgery. A young female presented with peritonitis, an acute systemic inflammatory response and biochemical features of acute renal failure secondary to urinary peritonitis. Laparotomy with drainage of urine from the peritoneal cavity and repair of the bladder perforation resulted in rapid resolution of the biochemical abnormalities.

scholarly journals The Incidence, Management, and Outcome of Penetrating Bladder Injuries in Civilians Resultant from Armed Conflict in Baghdad 2005-2006

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Firas G. Petros ◽  
Richard A. Santucci ◽  
Naimet K. Al-Saigh
Keyword(s):  
Primary Repair ◽  
Bladder Injury ◽  
Associated Injuries ◽  
Bladder Drainage ◽  
Young Males ◽  
Iraqi War ◽  
Missed Injury ◽  
War Zone ◽  
Civilian Trauma ◽  
Bladder Injuries

The purpose of this paper is to review the diagnosis, treatment, and outcomes of penetrating bladder injuries suffered by civilians in the Iraqi war zone.Materials and Methods.All civilian trauma cases received alive at Al-Yarmouk Teaching Hospital from January 2005 to August 2006 were reviewed for the presence of bladder injury.Results.533 cases of penetrating abdominal trauma were identified, of which 177 (33%) involved the genitourinary (GU) system and 64 (12%) involved the bladder. Most (70%) were young males, and most (55%) had grade IV injuries. Associated injuries occurred in 63/64 (98%) of patients. 3 patients had missed bladder injuries, and all of these had complications related to their missed injury. Bladder-related complications occurred in 11% of cases, and mortality in 13%, all due to extravesical injuries.Conclusions.Penetrating bladder injury among civilians in Baghdad war zone resulted in 64 cases in 18 months. The initial detection rate is very high (98%), and after primary repair, lasting complications are rare. Morbidities from missed injuries were severe hematuria and vesicorectal fistula. However, (3%) of vesicorectal fistulae healed spontaneously with prolonged bladder drainage. Associated injuries are the rule in penetrating bladder injury patients, and must be diligently investigated and treated.

scholarly journals Bladder injuries in emergency/expedited laparoscopic surgery in the absence of previous surgery: a case series

2012 ◽  
Vol 94 (3) ◽  
pp. e118-e120 ◽  
Author(s):  
BF Levy ◽  
J De Guara ◽  
PD Willson ◽  
Y Soon ◽  
A Kent ◽  
...  
Keyword(s):  
Case Series ◽  
Lower Abdominal Pain ◽  
Bladder Injury ◽  
Emergency Setting ◽  
Surgical Trainees ◽  
Bladder Injuries ◽  
Site Planning ◽  
Supervision And Training ◽  
Alternative Sites ◽  
And Training

INTRODUCTION The use of laparoscopy as a diagnostic and therapeutic tool is being used increasingly in the emergency setting with many of these procedures being performed by trainees. While the incidence of iatrogenic injuries is reported to be low, we present six emergency or expedited cases in which the bladder was perforated by the suprapubic trocar. CASES Three cases were related to the management of appendicitis, two to negative diagnostic laparoscopies for lower abdominal pain and one to an ectopic pregnancy. Management of the bladder injuries varied from a urinary catheter alone to laparotomy with debridement of the abdominal wall due to sepsis and later reconstruction. Four of the six cases were performed by registrars. CONCLUSIONS Although the incidence of bladder injury is low, its importance is highlighted by the large number of laparoscopies being performed. In addition to catheterisation of the patient, care must be taken with the insertion of low suprapubic ports and consideration should be made regarding alternative sites. Adequate laparoscopic supervision and training in port site planning is required for surgical trainees.

Cellular Origins of Endometriosis: Towards Novel Diagnostics and Therapeutics

2020 ◽  
Vol 38 (02/03) ◽  
pp. 201-215
Author(s):  
Caitlin E. Filby ◽  
Luk Rombauts ◽  
Grant W. Montgomery ◽  
Linda C. Giudice ◽  
Caroline E. Gargett
Keyword(s):  
Clinical Care ◽  
Diagnostic Delay ◽  
Delayed Diagnosis ◽  
Disease Recurrence ◽  
Diagnostic Tools ◽  
Unknown Etiology ◽  
Treatment Pathways ◽  
Retrograde Menstruation ◽  
Personalized Diagnosis ◽  
New Research

AbstractEndometriosis remains an enigmatic disease of unknown etiology, with delayed diagnosis and poor therapeutic options. This review will discuss the cellular, physiological, and genomic evidence of Sampson's hypothesis of retrograde menstruation as a cause of pelvic endometriosis and as the basis of phenotypic heterogeneity of the disease. We postulate that collaborative research at the single cell level focused on unlocking the cellular, physiological, and genomic mechanisms of endometriosis will be accompanied by advances in personalized diagnosis and therapies that target unique subtypes of endometriosis disease. These advances will address the clinical conundrums of endometriosis clinical care—including diagnostic delay, suboptimal treatments, disease recurrence, infertility, chronic pelvic pain, and quality of life. There is an urgent need to improve outcomes for women with endometriosis. To achieve this, it is imperative that we understand which cells form the lesions, how they arrive at distant sites, and what factors govern their ability to survive and invade at ectopic locations. This review proposes new research avenues to address these basic questions of endometriosis pathobiology that will lay the foundations for new diagnostic tools and treatment pathways.

Urethral diverticula

2017 ◽  
Author(s):  
Nadir I. Osman ◽  
Christopher R. Chapple
Keyword(s):  
Recurrent Urinary Tract Infection ◽  
Delayed Diagnosis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Voiding Cystourethrogram ◽  
Diagnostic Challenge ◽  
Urethral Catheterization ◽  
Female Population ◽  
Bladder Pain ◽  
Urethral Diverticula

Urethral diverticula (UD) are not uncommon, affecting up to 6% of the female population, but are in the majority of cases asymptomatic and of no clinical significance. They are thought to arise as a consequence of infection, obstruction, and subsequent rupture of a periurethral gland. UD often pose a significant diagnostic challenge, as symptoms are largely non-specific and easily confused with other conditions such as bladder pain syndrome and recurrent urinary tract infection. As such, both misdiagnosis and delayed diagnosis are common, to the frustration of both patients and surgeons. Traditional methods of diagnosis, such as voiding cystourethrogram, relied upon urethral catheterization and contrast instillation, and were associated with poor anatomical detail. Recent advances in imaging, particularly magnetic resonance imaging, have improved the diagnosis and staging of UD, and have allowed for more accurate preoperative planning.

Penetrating bladder injuries: Description of a clinical case

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 190-191
Author(s):  
R. Borsa ◽  
M. Governa ◽  
G. Aimé ◽  
D. Fraire ◽  
E. Baralis ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Clinical Case ◽  
Bladder Injury ◽  
Pelvic Ultrasound ◽  
Bladder Injuries

— A penetrating bladder injury in a youth due to impalement through the scrotum was successfully operated. Perforation was at the bottom and on the dome and the absence of a clinical uro-peritoneal picture was due to the plugging of the latter rupture by the omentum. Retrograde urethrocystography was negative and only pelvic ultrasound characterised the diagnosis, leading to an immediate explorative surgical approach.

scholarly journals INTERNAL HERNIA FOLLOWING LAPAROSCOPIC ROUX-EN-Y GASTRIC BY-PASS: INDICATIVE FACTORS FOR EARLY REPAIR

2019 ◽  
Vol 56 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Eduardo Pachu Raia dos SANTOS ◽  
Fernando SANTA CRUZ ◽  
Eduarda Araújo HINRICHSEN ◽  
Álvaro Antônio Bandeira FERRAZ ◽  
Josemberg Marins CAMPOS
Keyword(s):  
Internal Hernia ◽  
Early Stage ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Major Complication ◽  
Abdominal Distension ◽  
Recurrent Abdominal Pain ◽  
Early Repair ◽  
Gastric By Pass

ABSTRACT BACKGROUND: Internal hernia (IH) following laparoscopic Roux-en-Y gastric bypass (LRYGB) is a major complication that challenges the surgeon due to its non-specific presentation and necessity of early repair. Delayed diagnosis and surgical intervention of IH might lead to increased morbidity of patients and impairments in their quality of life. OBJECTIVE: To evaluate the predictive factors for early diagnosis and surgical repair of IH after LRYGB. METHODS: This study analyzed 38 patients during the postoperative period of LRYGB who presented clinical manifestations suggestive of IH after an average of 24 months following the bariatric procedure. RESULTS: The sample consisted of 10 men and 28 women, with a mean age of 37.5 years and a mean body mass index (BMI) of 39.6 kg/m2 before LRYGB. All patients presented pain, 23 presented abdominal distension, 10 had nausea and 12 were vomiting; three of them had dysphagia, three had diarrhea and one had gastro-esophageal reflux. The patients presented symptoms for an average of 15 days, varying from 3 to 50 days. Seventeen (45.9%) patients were seen once, while the other 20 (54.1%) went to the emergency room twice or more times. Exploratory laparoscopy was performed on all patients, being converted to laparotomy in three cases. Petersen hernia was confirmed in 22 (57.9%). Petersen space was closed in all patients and the IH correction was performed in 20 (52.6%) cases. The herniated loop showed signs of vascular suffering in seven patients, and two (5.3%) had irreversible ischemia, requiring bowel resection. CONCLUSION: The presence of recurrent abdominal pain is one of the main indicators for the diagnosis of IH after LRYGB. Patients operated at an early stage, even with negative imaging tests for this disease, benefited from rapid and simple procedures without major complications.

scholarly journals Cystic intra-abdominal masses in children

2017 ◽  
Vol 9 (3) ◽  
Author(s):  
Luisa Ferrero ◽  
Riccardo Guanà ◽  
Giulia Carbonaro ◽  
Maria Grazia Cortese ◽  
Luca Lonati ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Abdominal Distension ◽  
Abdominal Ultrasound ◽  
Mesenteric Cyst ◽  
Diagnostic Tools ◽  
Surgical Approaches ◽  
Radical Excision ◽  
Palpable Mass ◽  
Abdominal Masses

Benign intra-abdominal cystic masses in infancy are fairly uncommon and their etiopathogenesis, histology and clinical presentation differ significantly. Our aim is to report our experience in their treatment in order to discuss the best diagnostic and treatment modality. The medical records of 5 children (2M, 3F) with cystic intraabdominal masses referred to our hospital between November 2012 and September 2016, were retrospectively reviewed. All patients underwent open surgery and subsequent histopathologic analysis. Different clinical presentations, localizations of the masses, diagnostic tools, surgical approaches, histological examinations and outcomes were reviewed. Patients mean age was 5.4 years (range: 8 months-9 years). Two patients presented recurrent abdominal pain and abdominal distension; 1 patient had a palpable mass discovered incidentally and 2 complained acute abdominal pain. Routine laboratory tests, tumor markers and abdominal ultrasound were immediately done in all patients. Three patients underwent MRI and 1 abdominal CT. At laparotomy 2 hepatic cysts, 2 mesenteric cyst and 1 retroperitoneal cyst were discovered. Histology reports described: 1 hepatobiliary cystadenoma, 1 benign hepatic hamartoma and 3 cystic lymphangiomas (1 retroperitoneal and 2 mesenteric). There were no major postoperative complications, deaths, or recurrences in our series (follow-up 3-24 months). Despite the rarity of these lesions, benign cystic abdominal masses in children are not so uncommon and should be considered as causes of acute abdominal pain. The differential diagnosis is not always possible preoperatively. In our series, radical excision of the lesions was possible in all cases, allowing reliable histological results and avoiding recurrences.

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