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4.4.5 Postop care of visceral injury

Post-op management of urinary tract injury

  • Foley in situ for 7-10 days. Bladder lacerations typically heal well within 7 days of repair. 
  • Monitor for symptoms and signs of hydronephrosis, renal compromise or urinoma. The patient may be discharged home with instructions to return if symptoms arise.
  • Prophylactic antibiotics are not indicated.
  • Retrograde cystogram before Foley removed if urinoma suspected.
  • If flank/abdominal pain develop: consider CT scan or ultrasound.

Post-op management of bowel injury

  • Gradually increase diet as tolerated when bowel sounds are audible for injuries to the ileum or colon. A slower approach is required for upper GI injuries. 
  • Prophylactic antibiotics for full thickness injury.
  • Nasogastric drainage, diverting colostomy, and TPN are not required for simple laceration.
  • Monitor for signs of sepsis or anastomotic leak.
  • Inform patient of long term increased risk for bowel obstruction and fistula formation.
Updated on June 28, 2021

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