Department of General Surgery, Nicosia General Hospital, Nicosia, Cyprus.
Ren Fail. 2012;34(2):237-40. doi: 10.3109/0886022X.2011.647206. Epub 2012 Jan 20.
We report the fifth, to our knowledge, published case of spontaneous intraperitoneal bladder rupture after normal, vacuum-assisted in this occasion, vaginal delivery of a 29-year-old female patient. Diagnosis was established not by imaging or intraoperative findings, but, rather, by the examination and comparison of patient's blood, urine, and peritoneal fluid urea and creatinine levels, which, due to the patient's delayed referral and sequent development of uroperitoneum and hyponatremic renal pseudofailure, were abnormal and characteristic of her medical condition. The patient was successfully managed conservatively and was discharged the sixth day after admission. Due to the rare nature of such medical condition and based on the relative literature, we propose a diagnostic and management algorithm for such cases.
我们报告了第五例，据我们所知，是在一例 29 岁女性患者正常、真空辅助阴道分娩后，发生的自发性腹腔内膀胱破裂。诊断不是通过影像学或术中发现确定的，而是通过检查和比较患者的血液、尿液和腹腔液中的尿素和肌酐水平确定的，由于患者延迟就诊并继发出现尿腹和低钠性肾假性衰竭，这些水平异常且具有其特征性。患者成功地接受了保守治疗，并在入院后第六天出院。由于这种医疗情况非常罕见，并且基于相关文献，我们提出了一种针对这种情况的诊断和治疗算法。
