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Münsterer, Nadine R.; Werner, Evgenij and Münsterer, Oliver J. (2021): Successful Foley catheter tamponade of an epigastric vessel trocar injury in a toddler A case report. In: International Journal of Surgery Case Reports, Vol. 81, 105779

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INTRODUCTION AND IMPORTANCE: Injuries to the inferior epigastric vessels during laparoscopic surgery are rare but reported. They can lead to significant morbidity. We report the successful tamponade of a bleeding epigastric vessel during laparoscopic inguinal hernia repair in a child using a Foley catheter. A Foley catheter has not been routinely used in pediatric surgery for this indication so far. CASE PRESENTATION: A 32 -month-old boy underwent laparoscopic left inguinal hernia repair. During insertion of a 2 mm trocar, the left inferior epigastric vessels were lacerated, leading to a brisk bleed into the abdominal wall and into the abdomen through the trocar site during the procedure. When the hemorrhage was noted, the trocar was removed. The trocar tract was slightly dilated using a blunt forceps and a 12 F Foley catheter was introduced into the abdomen. The balloon was insufflated with 10 ml of water and the catheter was retracted towards the abdominal wall, tamponading the bleed. The inguinal hernia repair was completed, and after desufflating the catheter at the end of the procedure, the hemorrhage had stopped. CLINICAL DISCUSSION: Postoperatively, the hemoglobin had dropped by 1.5 g/c11 to 9.3 g/c11. The patient was observed and then discharged on the same day. Besides an additional 2 mm scar in the right lower quadrant, he had no further sequellae or adverse effects. CONCLUSION: Hemorrhage resulting from trocar injury of the inferior epigastric vessels during laparoscopy can be controlled by Foley catheter insertion and tamponade in children. Pediatric surgeons should be aware of this useful maneuver to manage this complication. 2021 Published by Elsevier Ltd on behalf of BS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license (Iii by IIC 11(1.-1.():).

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