A Rare Case of Paediatric Traumatic Intraperitoneal Urinary Bladder Rupture
PD01-PD03
Correspondence
LS Prabhanjan,
JN Boys Hostel, MGIMS Campus, Sevagram, Wardha-442102, Maharashtra, India.
E-mail: prabhanjanls27@gmail.com
Blunt trauma to the abdomen is widely encountered in the Emergency Department (ED) among both children and adults. Trauma is a major contributor to morbidity and mortality, even in the paediatric population. However, post-traumatic rupture of the urinary bladder in children is a rare occurrence. Hereby, the authors present a case report of a seven-year-old male, who was a victim of a bike versus truck collision, was brought to the Emergency Department in a state of haemodynamic shock. Two out of the three passengers on the motorcycle succumbed to their injuries on the spot. The survivor was rushed to the ED by ambulance. Upon initial examination, the patient was in a state of haemodynamic shock, with abdominal tenderness, lower abdominal guarding, and left inguinal subcutaneous emphysema. Fluid resuscitation was initiated at 10 mL/kg of crystalloids through intravenous access. Insertion of a Foley catheter revealed frank haematuria without urine output, and a Contrast-enhanced Computed Tomography (CECT) scan of the abdomen and pelvis showed gross haemoperitoneum. The patient was taken for emergency exploratory laparotomy, as the suspicion of bladder rupture was high. The procedure revealed a 3×4 cm rent in the dome of the urinary bladder. The bladder was repaired with Polydioxanone Suture 2-0 sutures in two layers. An abdominal drain was placed in the pelvic cavity, and the abdomen was closed in layers. The patient was discharged after seven days with an indwelling Foley catheter. The Foley catheter was kept in place for 14 days, after which it was removed following a successful trial voiding. On subsequent follow-up, the patient had no urinary complaints and recovered well. The present case report is significant as it addresses the bladder rupture of a young child who was a victim of a road accident. It is evident that double-layer repair of the bladder rupture with absorbable sutures yields significant outcomes even in children.