Rawat Jiledar, Singh Sudhir, Chaubey Digamber
Department of Paediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India.
King George's Medical University, Lucknow, Uttar Pradesh, India.
BMJ Case Rep. 2017 Aug 7;2017:bcr-2017-220943. doi: 10.1136/bcr-2017-220943.
A 4-year-old boy child presented with abdominal pain, haematuria, lower abdominal mass and urinary retention. There was no family history of bleeding. Ultrasound abdomen revealed an intravesical blood clot, rupture of the anterior bladder wall and perivesical haematoma. Contrast-enhanced CT (CECT) confirmed the findings. The child had a history of previous gum bleeding which prompted work-up for coagulation disorder. Investigations confirmed haemophilia. Following clotting factor replacement, surgical exploration was done. Intraoperatively, a 3 cm extraperitoneal, longitudinal tear on the anterior bladder wall was found along with haematoma in the bladder and perivesical space. Evacuation of the haematoma and repair of the bladder tear was performed. Postoperative period was uneventful, and the child was asymptomatic at 6-month follow-up. To the best of our knowledge, spontaneous bladder rupture has not been reported in a haemophilic child.
一名4岁男童出现腹痛、血尿、下腹部肿块及尿潴留。无出血家族史。腹部超声显示膀胱内血凝块、膀胱前壁破裂及膀胱周围血肿。增强CT（CECT）证实了这些发现。该患儿既往有牙龈出血史，因此对其进行了凝血障碍检查。检查确诊为血友病。在补充凝血因子后，进行了手术探查。术中发现膀胱前壁有一个3cm的腹膜外纵向撕裂口，同时膀胱及膀胱周围间隙有血肿。清除血肿并修复膀胱撕裂口。术后恢复顺利，6个月随访时患儿无症状。据我们所知，血友病患儿自发性膀胱破裂此前尚未见报道。
