Mahapatra Rajkumar Singha, Priyadarshi Vinod, Madduri Vijay Kumar Sarma, Pal Dilip Kumar
Department of Urology, Post Graduate Institute of Medical Education & Research, Kolkata, West Bengal, India.
BMJ Case Rep. 2014 Jun 12;2014:bcr2014204689. doi: 10.1136/bcr-2014-204689.
The diversity of objects that can be found in the urinary bladder often surpasses the urologist's imagination and mostly they are introduced per urethrally. Impalement injuries of the rectum with bladder perforation have been rarely reported. A high index of clinical suspicion is required to make the diagnosis of bladder perforation while assessing patients presenting with rectal impalement. In this interesting case, a young male child presented with haematuria and dysuria. He had a history of accidentally sitting on an agarbatti (Indian incense stick) stand while playing, followed by perianal pain which subsided spontaneously. Next day he presented with haematuria and dysuria. Clinical examination was inconclusive. On thorough investigation, a linear echogenic foreign body was found in the urinary bladder. The child was operated and the foreign body (incense stick) was removed. This is the first reported case of rectal impalement injury with incense stick, migrated to the urinary bladder in a 2-year-old child.
膀胱内发现的异物种类之多往往超出泌尿科医生的想象,而且大多数异物是经尿道进入的。直肠穿刺伤合并膀胱穿孔的病例鲜有报道。在评估直肠穿刺伤患者时,需要高度的临床怀疑指数才能诊断膀胱穿孔。在这个有趣的病例中,一名年轻男童出现血尿和排尿困难。他有在玩耍时不小心坐在香薰架上的病史,随后出现肛周疼痛,但疼痛自行缓解。第二天他出现血尿和排尿困难。临床检查结果不明确。经过全面检查,在膀胱内发现了一个线状强回声异物。该患儿接受了手术,异物(香薰棒)被取出。这是首例报道的2岁儿童因香薰棒直肠穿刺伤并迁移至膀胱的病例。