Bergeron Eric, Lewinshtein Daniel, Bure Lionel, Vallee Chantal
Departments of Surgery, Charles LeMoyne Hospital, Greenfield Park, Canada.
Departments of Surgery, Charles LeMoyne Hospital, Greenfield Park, Canada.
Int J Surg Case Rep. 2021 Apr;81:105783. doi: 10.1016/j.ijscr.2021.105783. Epub 2021 Mar 16.
Spontaneous urinary bladder rupture is a rare complication of urosepsis. Its co-occurrence with pneumoperitoneum is even more unusual.
A 73-year-old patient presented with acute retention with mild lower abdominal pain and difficulty with urinary voiding and cystitis. He was treated with bladder catheter and antibiotics. After one month, he suddenly developed peritonitis and shock. Pneumoperitoneum was observed on a chest x-ray. An emergent laparotomy was performed and a perforation of the bladder secondary to necrosis of part of the wall was found and resected. The patient recovered satisfactorily after the surgical intervention.
Spontaneous bladder rupture is a life-threatening condition that could be missed. Surgical intervention is mandatory to rule out other more probable causes of peritonitis and to manage the bladder perforation itself.
Pneumoperitoneum is rarely secondary to a bladder perforation. Immediate surgical intervention is required in order to avoid delays in treating any intra-abdominal condition including a bladder wall perforation.
自发性膀胱破裂是尿脓毒症的一种罕见并发症。其与气腹同时出现则更为罕见。
一名73岁患者因急性尿潴留伴轻度下腹痛、排尿困难及膀胱炎前来就诊。给予膀胱导尿及抗生素治疗。一个月后，他突然出现腹膜炎和休克。胸部X线检查发现气腹。急诊行剖腹探查术，发现膀胱壁部分坏死继发穿孔并进行了切除。手术干预后患者恢复良好。
自发性膀胱破裂是一种可能被漏诊的危及生命的疾病。必须进行手术干预以排除其他更可能导致腹膜炎的原因，并处理膀胱穿孔本身。
气腹很少继发于膀胱穿孔。需要立即进行手术干预，以避免延误治疗包括膀胱壁穿孔在内的任何腹腔内疾病。
