Bladder injury mimicking acute renal failure after cesarean section: a diagnostic challenge and minimally invasive management.
The reported incidence of bladder injury after cesarean section ranges from 0.14% to 0.94%. Most of the injuries were found intraoperatively. Delayed presentation is rare. We report a patient with bladder perforation presented with 'acute renal failure' and ascites 14 days after an uneventful cesarean section. Her clinical picture and initial presentation mimicked those of ureteric injury. Conventional cystography failed to demonstrate the bladder perforation. Computed tomography cystography clarified the diagnosis. Subsequent laparoscopic bladder repair resulted in quick and smooth recovery. This case highlights the pitfall of conventional cystography and the successful use of laparoscopy in management of this urologic condition. Literature was reviewed for this condition and its management.
Tai
Chi Kin
CK
Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. dominctai@netvigator.com
Li
Shu Keung
SK
Hou
See Ming
SM
Fan
Chi Wai
CW
D058186:Acute Kidney Injury / Q000175:diagnosis*; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures; D012307:Risk Factors; D013997:Time Factors; D001743:Urinary Bladder / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*