Snapshot quiz 19/6

Published: 02/28/2019

Authors: Phua SSH, Tang MH, Chia CLK and Lee DJK

This patient’s bladder was perforated during insertion of a suprapubic port. A Pfannensteil incision was made and the bladder was found to be perforated at the dome,where the drain had been inserted. The perforation was repaired in two layers. The urinary catheter was left in situ for a month,after which the patient made an uneventful recovery.The incidence of bladder injury secondary to instrumentation in laparoscopic surgery is 0∙3–0∙5 per cent. Management may be either conservative with insertion of an indwelling catheter, or surgical repair by a laparoscopic or open method. This serves as a reminder that surgeons should exercise caution during insertion of a suprapubic port. Air in the urinary catheter bag is suggestive of bladder perforation.