Ahmed Jamil, Mallick Ismail H, Ahmad Syed Muzaffar
Department of General Surgery, Scunthorpe General Hospital Scunthorpe DN15 7BH UK.
Cases J. 2009 May 14;2:7004. doi: 10.1186/1757-1626-2-7004.
Spontaneous rupture of the urinary bladder is a rare event. Patients usually present with features of peritonitis and diagnosis is usually made at operation. The morbidity and mortality rate is very high in these groups of patients.
We present a case of a 47-year-old caucasian woman who was known to have transitional cell carcinoma of the urinary bladder who presented with features of peritonitis. An exploratory laparotomy revealed free perforation of the urinary bladder. The perforation was closed. However, on the second post-operative day she started draining urine from the abdominal drain and was taken back to the operating theatre. The stitches in the urinary bladder had given off and she underwent radical cystectomy along with double barrel cutaneous ureterostomies. Peritoneal biopsies revealed disseminated transitional cell carcinoma in the peritoneum. She made a slow postoperative recovery.
Perforation of the urinary bladder should be considered in patients presenting with peritonitis particularly with a previous history of urinary bladder cancer.
膀胱自发性破裂是一种罕见事件。患者通常表现出腹膜炎的特征，诊断通常在手术时做出。这类患者的发病率和死亡率非常高。
我们报告一例47岁的白种女性患者，已知患有膀胱移行细胞癌，表现出腹膜炎的特征。剖腹探查发现膀胱游离穿孔。穿孔被缝合。然而，术后第二天她开始从腹腔引流管引流尿液，并被带回手术室。膀胱的缝线脱落，她接受了根治性膀胱切除术及双侧输尿管皮肤造口术。腹膜活检显示腹膜内有弥漫性移行细胞癌。她术后恢复缓慢。
对于出现腹膜炎的患者，尤其是有膀胱癌病史的患者，应考虑膀胱穿孔的可能。
