Obstructive uropathy secondary to pneumoperitoneum in a patient with ileal conduit.

Pneumoperitoneum has become an established first step when performing laparoscopic procedures. No specific guidelines are available for creating pneumoperitoneum in patients with ostomies. We present a patient with a urostomy (ileal conduit), undergoing a laparoscopic cholecystectomy. After surgery the stoma became edematous leading to obstructive uropathy and renal insufficiency. We suggest that the pneumoperitoneum should be created at low pressures among patients with ostomies and further recommend that a drainage tube is placed in the ileal conduit to ensure unobstructed drainage of urine.