An unusual cause of abdominal distension: intraperitoneal bladder perforation secondary to intermittent self-catheterisation

Jennifer Martin*, Liam Convie, David Mark, Mark McClure

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

We report a strikingly unusual case of traumatic intraperitoneal perforation of an augmented bladder from clean intermittent self-catheterisation (CISC), which presented a unique diagnostic challenge. This case describes a 48-year-old T1 level paraplegic, who had undergone clamshell ileocystoplasty for detrusor overactivity, presenting with abdominal distension, vomiting and diarrhoea. Initial investigations were suggestive of disseminated peritoneal malignancy with ascitic fluid collections, but the ascitic fluid was found to be intraperitoneal urine from a perforation of the urinary bladder. This was associated with an inflammatory response in the surrounding structures causing an appearance of colonic thickening and omental disease. Although the diagnostic process was complex due to this patient's medical history, the treatment plan initiated was non-operative, with insertion of an indwelling urinary catheter and radiologically guided drainage of pelvic and abdominal collections. Overdistension perforations of augmented urinary bladders have been reported, but few have described perforation from CISC.

Original languageEnglish
Article number2014207097
JournalBMJ Case Reports
Volume2015
DOIs
Publication statusPublished - 25 Feb 2015

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Intermittent Urethral Catheterization
Catheterization
Urinary Bladder
Ascitic Fluid
Urinary Catheters
Indwelling Catheters
Vomiting
Drainage
Diarrhea
Urine
Neoplasms
Therapeutics

Cite this

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abstract = "We report a strikingly unusual case of traumatic intraperitoneal perforation of an augmented bladder from clean intermittent self-catheterisation (CISC), which presented a unique diagnostic challenge. This case describes a 48-year-old T1 level paraplegic, who had undergone clamshell ileocystoplasty for detrusor overactivity, presenting with abdominal distension, vomiting and diarrhoea. Initial investigations were suggestive of disseminated peritoneal malignancy with ascitic fluid collections, but the ascitic fluid was found to be intraperitoneal urine from a perforation of the urinary bladder. This was associated with an inflammatory response in the surrounding structures causing an appearance of colonic thickening and omental disease. Although the diagnostic process was complex due to this patient's medical history, the treatment plan initiated was non-operative, with insertion of an indwelling urinary catheter and radiologically guided drainage of pelvic and abdominal collections. Overdistension perforations of augmented urinary bladders have been reported, but few have described perforation from CISC.",
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An unusual cause of abdominal distension: intraperitoneal bladder perforation secondary to intermittent self-catheterisation. / Martin, Jennifer; Convie, Liam; Mark, David; McClure, Mark.

In: BMJ Case Reports, Vol. 2015, 2014207097, 25.02.2015.

Research output: Contribution to journalArticle

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