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11–14 APRIL, 2018, HELSINKI, FINLAND
MATERIAL AND METHODS
An 8-year-old boy was brought to our emergency department as a victim of traffic accident. During
admission, he was tachypneic and restless but his vital functions were stable. He had abdominal
tenderness in lower quadrants and a fracture in the right tibia. The soft tissues over pubic and both
iliac bones were markedly painful and edematous. There was no blood at the external meatus. Urine
analysis was normal. Ultrasonography and computerized tomography showed no intrabdominal
solid organ injury but there were free intraperitoneal fluid, severe pelvic hematoma and pubic bone
fractures. He was admitted to intensive care unit with diagnosis of multiple trauma. Because acute
abdomen developed despite maximal supportive measures, he underwent laparoscopic exploration
on 4
th
day of hospitalization.
RESULTS
We found a perforation site at posterior bladder wall after aspiration of abundant intraabdominal
fluid. Then, two additional ports were inserted and the perforation site was repaired as two layers.
Rectovesical fossa was drained. In postoperative period, peritonitis resulting in prolonged drainage
was developed. After removing the drain on the postoperative day 9, the patient was doing well and
discharged.
CONCLUSIONS
Although delayed diagnosis of intraperitoneal bladder perforation causes to increased morbidity,
laparoscopic repair can be successfully performed.
09:42–09:54
Discussion