Published online Oct 26, 2020. doi: 10.12998/wjcc.v8.i20.4993
Peer-review started: July 15, 2020
First decision: August 8, 2020
Revised: August 10, 2020
Accepted: September 16, 2020
Article in press: September 16, 2020
Published online: October 26, 2020
Processing time: 103 Days and 0.4 Hours
Spontaneous bladder rupture is relatively rare, and common causes of spontaneous bladder rupture include bladder diverticulum, neurogenic bladder dysfunction, gonorrhea infection, pelvic radiotherapy, etc. Urinary bladder perforation caused by urinary catheterization mostly occurs during the intubation process.
Here, we describe an 83-year-old male who was admitted with 26 h of middle and upper abdominal pain and a history of long-term catheterization. Physical examination and computed tomography of the abdomen supported the diagnosis of diffuse peritonitis, most likely from a perforated digestive tract organ. Laparoscopic exploration revealed a possible digestive tract perforation. Finally, a perforation of approximately 5 mm in diameter was found in the bladder wall during laparotomy. After reviewing the patient’s previous medical records, we found that 1 year prior the patient underwent an ultrasound examination showing that the end of the catheter was embedded into the mucosal layer of the bladder. Therefore, the bladder perforation in this patient may have been caused by the chronic compression of the urinary catheter against the bladder wall.
For patients with long-term indwelling catheters, there is a possibility of bladder perforation, which needs to be dealt with quickly.
Core Tip: Here, we describe a patient, who had a long-term indwelling catheter and complained of abdominal pain, with a bladder perforation that was mistaken for a gastrointestinal perforation. We found that 1 year prior the patient underwent an ultrasound examination showing that the end of the catheter was embedded in the mucosal layer of the bladder. Therefore, the bladder perforation in this patient may have been caused by the chronic compression of the urinary catheter against the bladder wall. This case reminds us that for patients with long-term indwelling catheters, bladder perforation may occur and needs to be dealt with timely.