We report a case of an iatrogenic bladder perforation sustained during laparoscopic lysis of adhesions performed for small bowel obstruction. The only sign, discovered by the anesthesiology team, was an inflated urinary catheter collection bag. This case revalidates the “catheter bag” sign and advocates for the placement of an indwelling transurethral urinary catheter before surgical incision in high-risk patients with previous pelvic and/or bladder pathology. In addition, vigilance from anesthesia providers and commitment to communication between anesthesia, surgical, and nursing care teams is emphasized to quickly discover complications and treat accordingly.
From the Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Accepted for publication August 20, 2019.
The authors declare no conflicts of interest.
Address correspondence to Jeffrey S. Grzybowski, MD, Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave B6/319 CSC Madison, WI 53792. Address e-mail to JGrzybowski@uwhealth.org.