Abstract
A 67-year-old man who was diagnosed with invasive bladder cancer and underwent radical cystectomy and construction of an ileal orthotopic neobladder four years earlier was admitted to our hospital on an emergency basis because of gradually increasing abdominal pain and nausea after drinking. Abdominal CT scan showed moderate degree of fluid accumulation around the liver and spleen. Emergency laparotomy under a diagnosis of panperitonitis was performed. A perforation 2 mm in diameter was disclosed at the top of the neobladder. Panperitonitis due to neobladder perforation was diagnosed. Debridment around the perforation and primary closure were performed. The perforation of an ileal neobladder is quite a rare complication. Possible causes include hyperextension, adhesions to the surroundings, clean intermittent self catheterization (CIC), and infection. The present case is likely to be caused by CIC and hyperextension that may result from poorly controlled CIC. It is necessary to keep this complication in mind when we diagnose patients with peritonitis who have a history of construction of an ileal orthotopic neobladder.
