Morita Jun, Naoe Michio, Nakasato Takehiko, Ogawa Yoshio
Department of Urology, Showa University School of Medicine, Tokyo, Japan.
Korean J Urol. 2012 Jun;53(6):435-7. doi: 10.4111/kju.2012.53.6.435. Epub 2012 Jun 19.
Impalement injury of the urinary bladder, especially secondary to rectal impalement, is extremely rare. In this case, a 31-year-old man sustained a steel pipe impalement injury through his perirectal region. He presented with gross hematuria, abdominal defense, and a penetrating wound. On the basis of the computed tomography findings and abdominal defense, we suspected a through-and-through bladder perforation from the rectal space to the intraperitoneum. Laparotomy revealed a through-and-through bladder perforation as well as damage to the right ureter, 3 distinct ileal injuries, and rectal anterior, anal, and right seminal vesicle injuries. Surgical repair of each damaged site was undertaken. The prompt diagnosis and surgical repair ensured good postoperative recovery.
膀胱穿刺伤,尤其是继发于直肠穿刺伤的情况极为罕见。在此病例中,一名31岁男性经直肠区域遭受钢管穿刺伤。他出现肉眼血尿、腹部压痛及一处贯通伤。基于计算机断层扫描结果及腹部压痛,我们怀疑存在从直肠间隙至腹腔的膀胱全层穿孔。剖腹探查显示膀胱全层穿孔,同时右输尿管受损、3处不同的回肠损伤以及直肠前部、肛门和右侧精囊损伤。对每个受损部位进行了手术修复。及时的诊断和手术修复确保了术后的良好恢复。