Intraperitoneal Perforation

™ Small intraperitoneal perforation can be managed as a extraperitoneal one.

™ If abdominal distension is present and bleeding is under control, stop resection.

™ Insert a 10-mm laparoscopic port midway between umbilicus and the anterior superior iliac spine.

™ Insert a drain through the port.

™ Remove the port and fix the drain.

™ Place a 22-Fr transurethral catheter.

™ After 10 days, check cystogram and removal of the catheter in absence of leakage.

™ If the bleeding is not controllable, perform an inferior laparotomy.

™ Close the bladder defect with Monocryl 3/0 single stitches.

™ Place an intraperitoneal and an extraperito-neal drain.

™ Double drainage of the bladder with transu-rethral and suprapubic catheter.

™ After 7 days, check the cystogram and remove the catheter.

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