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膀胱自发性破裂;病例报告及文献综述

Spontaneous rupture of the urinary bladder (SRUB); A case report and review of literature.

作者信息

Sawalmeh Haitham, Al-Ozaibi Labib, Hussein Ahmed, Al-Badri Faisal

机构信息

Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.

Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates.

出版信息

Int J Surg Case Rep. 2015;16:116-8. doi: 10.1016/j.ijscr.2015.09.035. Epub 2015 Oct 3.

Abstract

INTRODUCTION

Spontaneous urinary bladder rupture is a rare urological emergency. It is usually secondary to an underlying pathology and it is an uncommon complication of urosepsis. We report a case of spontaneous urinary bladder rupture as a complication of urosepsis in a 67 year old male patient, who was admitted as a case of left diabetic foot and urinary tract infection.

CASE PRESENTATION

A 67 year old male patient with a long standing indwelling urinary catheter and chronic cystitis developed acute peritonitis. Intraoperative finding was ruptured urinary bladder.

DISCUSSION

A few cases of spontaneous urinary bladder rupture due to infection were found in literature. The majority of the patients present with diffuse abdominal pain, and tenderness due to chemical peritonitis. In the majority of cases the bladder perforation was diagnosed intra-operative.

CONCLUSION

A diagnosis of spontaneous perforation of the bladder should be considered in patients presenting with an acute abdomen. The general surgeon is more likely than the urologist to encounter such patients in the first instance. There should be a high index of suspicion in patients with an acute abdomen and have associated urinary bladder condition.

摘要

引言

自发性膀胱破裂是一种罕见的泌尿外科急症。它通常继发于潜在的病理状况,是泌尿道感染的一种罕见并发症。我们报告一例67岁男性患者,因糖尿病足和尿路感染入院,其自发性膀胱破裂作为泌尿道感染的并发症。

病例介绍

一名67岁男性患者,长期留置导尿管且患有慢性膀胱炎,发生了急性腹膜炎。术中发现膀胱破裂。

讨论

文献中发现了一些因感染导致的自发性膀胱破裂病例。大多数患者表现为弥漫性腹痛以及化学性腹膜炎引起的压痛。在大多数病例中,膀胱穿孔是在术中诊断出来的。

结论

对于出现急腹症的患者,应考虑膀胱自发性穿孔的诊断。普通外科医生比泌尿外科医生更有可能首先遇到此类患者。对于患有急腹症且伴有膀胱相关疾病的患者,应保持高度怀疑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f37/4643468/f734b51acbb9/gr1.jpg

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