Murata Ryohei, Kamiizumi Yo, Tani Yasuhiro, Ishizuka Chihiro, Kashiwakura Sayuri, Tsuji Takeshi, Kasai Hironori, Haneda Tsutomu, Yoshida Tadashi, Katano Hidenori, Ito Koji
Department of Surgery, Iwamizawa Municipal Hospital, Iwamizawa-shi 068-8555, Japan.
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo-shi 060-8648, Japan.
J Surg Case Rep. 2018 Sep 29;2018(9):rjy253. doi: 10.1093/jscr/rjy253. eCollection 2018 Sep.
We report a case of spontaneous rupture of the urinary bladder (SRUB) due to bacterial cystitis in a 76-year-old woman with chief complaint of abdominal pain a day before presentation. She had fever (38.0°C), and her systolic blood pressure dropped to 70 mmHg; she was referred to our hospital, where she was admitted with a diagnosis of ileus. However, her abdominal pain worsened the following day, and abdominal CT showed free air. Emergency laparotomy was performed for suspicion of digestive tract perforation, which revealed a small hole at the dome of the urinary bladder and another at the peritoneum. Suture repair was performed. We reviewed the abdominal CT on admission and noted that the perforation of the urinary bladder was present during admission, whereas that of the peritoneum occurred the following day. SRUB is rare, and bacterial cystitis rarely causes it; thus, accurate diagnosis and proper treatment are essential.
我们报告一例76岁女性因细菌性膀胱炎导致膀胱自发性破裂（SRUB）的病例。患者就诊前一天主要诉腹痛。她有发热（38.0°C），收缩压降至70mmHg；被转诊至我院，入院诊断为肠梗阻。然而，第二天她的腹痛加重，腹部CT显示有游离气体。因怀疑消化道穿孔行急诊剖腹探查术，结果显示膀胱顶部有一个小孔，腹膜处有另一个小孔。进行了缝合修复。我们复查了入院时的腹部CT，发现入院时膀胱已有穿孔，而腹膜穿孔发生在第二天。膀胱自发性破裂很罕见，细菌性膀胱炎很少导致这种情况；因此，准确诊断和恰当治疗至关重要。
