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Organo Oficial de la Sociedad Mexicana de Urología

2024, Number 6

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Rev Mex Urol 2024; 84 (6)

Laparoscopic management of post-traumatic fistula: brief review of the literature on the subject of a case

Piña-Zarrabal SA, Blas-Reina A, Vázquez-Gálvez A, Vega-Castro R, García-Martínez FE, Jurado-Félix A, López-Ríos RA, Tafoya-Díaz S

Language: Spanish
References: 24
Page: 1-11
PDF size: 190.47 Kb.


ABSTRACT

Case description: a 41-year-old male patient was admitted to the emergency department for penetrating pelvic trauma due to a firearm projectile. He required exploratory laparotomy in which a bladder and rectal injury was found, both grade V, performing initially repair with primary closure of the bladder and rectum. In the post-surgical followup, an abnormal communication was found between the bladder, rectum and soft tissues of the gluteal region. He was protocolized for laparoscopic repair of vesico-rectal fistula.
Relevance: in Mexico, gunshot wounds represent the most common cause of penetrating abdominal trauma. Injuries to the involved organs retain a high risk of developing subsequent fistulas. Clinical implications: to our knowledge, this review represents the first report of minimally invasive management of bladder-rectal fistula of post-traumatic origin.
Conclusions: penetrating trauma is an increasingly frequent cause of urinary tract injury, and the development of complications implies a considerable impact on patients’ quality of life. The management of urinary fistulas secondary to trauma is not well standardized. This report demonstrates the feasibility of laparoscopic approach for the resolution of vesicorectal fistulas.


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