Okumura A, Kimura H, Takagi R, Tukada S
Department of Urology, Niigata Rousai Hospital.
Hinyokika Kiyo. 1991 Nov;37(11):1543-6.
We report two cases of traumatic bladder rupture complicated by multiple organ failure (MOF). The first patient had an extraperitoneal bladder rupture and right femoral bone fracture, which were treated conservatively. However, intrapelvic abscess and adult respiratory distress syndrome (ARDS) which was caused by fat embolism resulted in MOF. The second patient who had been under treatment for malignant lymphoma for three years had an intraperitoneal bladder rupture with ruptures of spleen, intestine and diaphragm. We closed the defects in the bladder, intestine, diaphragm and performed splenectomy. We also provided suprapubic cystostomy and a urethral catheter. However, wound abscess and hepatic failure occurred postoperatively. She died of MOF 20 days after the operation. We stress that in the treatment of bladder rupture, intensive chemotherapy for infection must be done when there are complications of other visceral injuries.
我们报告两例创伤性膀胱破裂并发多器官功能衰竭（MOF）的病例。首例患者为腹膜外膀胱破裂合并右股骨骨折，采取保守治疗。然而，盆腔内脓肿以及由脂肪栓塞引起的成人呼吸窘迫综合征（ARDS）导致了多器官功能衰竭。第二例患者患有恶性淋巴瘤，已接受三年治疗，此次发生腹膜内膀胱破裂，同时伴有脾脏、肠道和膈肌破裂。我们对膀胱、肠道和膈肌的缺损进行了修补，并实施了脾切除术。我们还进行了耻骨上膀胱造瘘术并留置了尿道导管。然而，术后出现了伤口脓肿和肝功能衰竭。她在术后20天死于多器官功能衰竭。我们强调，在治疗膀胱破裂时，如果存在其他内脏损伤的并发症，必须针对感染进行强化化疗。
