Chen S-C, Chang J-M, Wang C-S, Kuo C-H, Chen H-C
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Clin Nephrol. 2009 Nov;72(5):394-6. doi: 10.5414/cnp72394.
Intraperitoneal bladder rupture is a rare cause of acute abdomen with bloody ascites. We report herein the case of a patient who had alcoholic liver cirrhosis and multiple liver nodules, and experienced acute bloody ascites and oliguric acute renal failure in association with intraperitoneal bladder rupture. A 33-year-old male suffered from acute abdominal pain and oliguria following consumption of a large amount of alcohol and after blunt abdominal trauma. He was also found to have acute renal failure and newly onset bloody ascites that rapidly subsided following transurethral catheter drainage. Computed tomography cystography revealed intraperitoneal extravasation of contrast from the dome of the bladder, suggestive of intraperitoneal bladder rupture. The patient received surgical repair and was discharged with full recovery. This case shows that it is important for physicians to be aware of the possibility of intraperitoneal bladder rupture after alcohol consumption accompanied with abdominal blunt trauma. In particular, it has diagnostic complications for underlying liver tumors.
腹膜内膀胱破裂是导致急性腹痛伴血性腹水的罕见原因。我们在此报告一例患有酒精性肝硬化和多个肝结节的患者,该患者因腹膜内膀胱破裂出现急性血性腹水和少尿性急性肾衰竭。一名33岁男性在大量饮酒并遭受腹部钝性创伤后出现急性腹痛和少尿。他还被发现患有急性肾衰竭和新出现的血性腹水,经尿道导管引流后腹水迅速消退。计算机断层扫描膀胱造影显示膀胱顶部有造影剂腹膜外渗,提示腹膜内膀胱破裂。患者接受了手术修复,出院时已完全康复。该病例表明,医生认识到饮酒伴腹部钝性创伤后腹膜内膀胱破裂的可能性很重要。特别是,对于潜在的肝脏肿瘤存在诊断并发症。