AN UNUSUAL CASE OF PYOPERITONEUM SECONDARY TO GANGRENOUS URINARY BLADDER FOLLOWING NON-TRAUMATIC VAGINAL DELIVERY Jhirwalm@aiimsjodhpur.edu.in

 

AN UNUSUAL CASE OF PYOPERITONEUM SECONDARY TO GANGRENOUS URINARY BLADDER FOLLOWING NON-TRAUMATIC VAGINAL DELIVERY

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India

Oral or Poster

Gangrenous urinary bladder with rupture is a unusual condition following a non traumatic vaginal delivery

A 39-year age young female admitted in emergency surgery Department with complaints of pain abdomen, abdominal distention, decrease urine output and fever for last 10 days. She had history of fourth non-traumatic vaginal delivery before 10 days in primary health care centre. All blood investigations were normal except raised leucocyte count (34000/mm3). The ultrasound and computed tomography (CT) scan showed a gross intra-peritoneal collection with dilated small bowel. The patient diagnosed with postpartum pyoperitoneum with septicemia.

She underwent for the diagnostic laparoscopy. Operative findings shown 2500 ML pus with flacks, gangrenous urinary bladder with large perforation and dense interbowel adhesions. Laparoscopic adhesiolysis, peritoneal lavage and bladder repair was performed. Postoperative period was uneventful.

Postpartum gangrenous urinary bladder is extremely rare condition and associated with significant morbidity and mortality. It is suspected when postpartum abdominal pain is associated with peritoneal collection and fever. Also, there is a challenge to managing such patients laparoscopically.