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Year : 2017  |  Volume : 13  |  Issue : 1  |  Page : 63-65

Laparoscopic repair of intra-abdominal bladder perforation in preschool children

1 Department of Paediatric Surgery, John Hunter Children's Hospital, Newcastle, Australia
2 Department of Surgery, Westmead Hospital, Sydney, Australia
3 Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Australia

Correspondence Address:
Aniruddh V Deshpande
School of Medicine and Public Health, John Hunter Children's Hospital, University of Newcastle, Locked Bag 1, Hunter Region Mail Centre NSW 2310
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-9941.181762

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Intraperitoneal bladder rupture is uncommon in very young children, but its incidence may increase with increasing use of seat and lap belts. To the best of our knowledge, there are no prior reports of laparoscopic repair of this injury in children. We describe two recent cases and discuss useful technical points that facilitate a successful laparoscopic repair. Both our patients were preschool age girls who sustained seat and lap belt injuries. Contrast computed tomography scan suggested a large amount of free peritoneal fluid and cystogram confirmed intraperitoneal bladder perforation (isolated injury). The injury was repaired using delayed absorbable sutures and intracorporeal suturing (continuous in 1, interrupted in 1) using a 3 port laparoscopic technique. Meticulous peritoneal lavage was carried out to minimise urinary peritonitis and the bladder as well as the peritoneal cavity were drained. Check cystograms (day 7) revealed no leaks. Young girls appear to be at risk of intraperitoneal bladder injuries following lap belt injuries. After exclusion of life-threatening injuries and concurrent abdominal injuries which need rapid control or preclude pneumoperitoneum, a laparoscopic repair can be safely performed.


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