Urology Unit, Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Int J Infect Dis. 2010 Sep;14 Suppl 3:e250-2. doi: 10.1016/j.ijid.2009.10.006. Epub 2010 Feb 1.
Spontaneous bladder perforation secondary to tuberculosis (TB) is very rare. Only three cases have been reported so far in the literature. Due to its rarity, the diagnosis of spontaneous bladder perforation is often missed. Confirmation of TB via culture takes a long time and starting empirical treatment for TB is necessary. We relate our experience with a young woman who presented with clinical features of a perforated appendix and was only diagnosed with bladder perforation during laparotomy. She also had distal right ureteral stricture and left infundibular stenosis. The provisional diagnosis of TB was attained via typical histopathological features and a positive Mantoux test. She was started empirically on anti-TB treatment and recovered without any complications. Urine culture after 6 weeks confirmed the diagnosis of TB.
自发性膀胱穿孔继发于结核（TB）非常罕见。迄今为止，文献中仅报道了 3 例。由于其罕见性，自发性膀胱穿孔的诊断常常被遗漏。通过培养来确认结核需要很长时间，因此有必要开始经验性的抗结核治疗。我们报告了一位年轻女性的病例，她表现为阑尾穿孔的临床特征，直到剖腹探查时才被诊断为膀胱穿孔。她还伴有右输尿管下段狭窄和左侧漏斗部狭窄。通过典型的组织病理学特征和结核菌素试验阳性，我们获得了结核的暂定诊断。她开始接受经验性的抗结核治疗，没有出现任何并发症并康复。6 周后的尿液培养证实了结核的诊断。
