# A Rare Complication of Bladder Injury Following Laparoscopic Appendectomy: A Case Report and Literature Review

## TL;DR

This paper reports a rare case of bladder injury after laparoscopic appendectomy and reviews how such injuries are diagnosed and managed.

## Contribution

The novelty lies in presenting a case of delayed bladder injury detected via creatinine levels in drain fluid, adding to the literature on this rare complication.

## Key findings

- Bladder injury occurred after laparoscopic appendectomy and was detected on postoperative day 3.
- Creatinine levels in drain fluid helped confirm the bladder injury.
- Literature review highlights the rarity and management of such iatrogenic injuries.

## Abstract

Acute appendicitis is widely recognized as the leading cause of acute abdominal pain in patients seeking hospital treatment. The standard of care and golden approach has traditionally involved performing an appendicectomy, which nowadays is more often performed using laparoscopic techniques. As with any laparoscopic procedure, there is a risk of iatrogenic organ injury, particularly during trocar insertion; one such organ at risk is the urinary bladder (0.17-0.73%). Most reported cases of urinary bladder injuries occur due to trocar insertion in the suprapubic area. In this report, we present a case of a patient with an occult bladder injury diagnosed postoperatively on day 3 via creatinine level in drain fluid after undergoing a laparoscopic appendicectomy. We also include a review of the literature regarding the presentation, diagnosis, and management of this complication.