ESPU Congress 2018 - Abstract Book

171 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