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膀胱自发性破裂致新发大量腹水伴急性肾损伤

New-Onset Massive Ascites With Acute Kidney Injury Due to Spontaneous Rupture of the Urinary Bladder.

作者信息

Chien-Hua Chen, Yun-Te Chang, Neng-Chyan Huang, Fong-Dee Huang

机构信息

Chiayi Branch, Taichung Veterans General Hospital Department of Emergency Medicine Chiayi Taiwan.

Kaohsiung Veterans General Hospital Department of Emergency Medicine No. 386, Ta-Chung 1st Rd. Kaohsiung 813 Taiwan.

出版信息

J Acute Med. 2019 Jun 1;9(2):64-68. doi: 10.6705/j.jacme.201906_9(2).0004.

Abstract

Spontaneous rupture of the urinary bladder (SRUB) is a rare urological emergency associated with urinary ascites and apparent acute kidney injury. The clinical course can be severe or lethal if no early diagnosis is achieved. We present a 44-year-old woman with type 2 diabetes mellitus had progressive abdominal fullness, poor appetite, dyspnea, and lower legs edema for two days. Laboratory studies present as acute kidney injury. Abdominal sonogram and computed tomogram (CT) revealed massive ascites. Her ascitesrelieved dramatically after Foley catheter indwelling, and daily urine amount was about 5,000 mL. Urinary bladder rupture was found after CT cystography. She received surgical repair of the ruptured urinary bladder, and cystometry revealed detrusor arefl exia. Then she was discharged uneventfully.

摘要

膀胱自发性破裂(SRUB)是一种罕见的泌尿外科急症,与尿腹水和明显的急性肾损伤有关。如果不能早期诊断,临床过程可能很严重甚至致命。我们报告一名44岁2型糖尿病女性,出现进行性腹胀、食欲不振、呼吸困难和小腿水肿两天。实验室检查显示为急性肾损伤。腹部超声和计算机断层扫描(CT)显示大量腹水。留置 Foley 导管后腹水明显缓解,每日尿量约5000 mL。CT膀胱造影后发现膀胱破裂。她接受了膀胱破裂的手术修复,膀胱测压显示逼尿肌无反射。然后她顺利出院。

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