Heo Yoonjung, Kim Dong Hun
Department of Trauma Surgery, Trauma Center, Dankook University Hospital, Cheonan, Republic of Korea.
Trauma Case Rep. 2021 Aug 24;35:100520. doi: 10.1016/j.tcr.2021.100520. eCollection 2021 Oct.
Urinary bladder rupture is commonly due to blunt abdominal trauma rather than penetrating trauma. Intraperitoneal bladder rupture (IBR) is a concrete indication of surgical management. On the other hand, surgeons should perform surgeries in patients with extraperitoneal bladder rupture (EBR) solely in complicated cases. Uncomplicated EBR is managed conservatively. Laparoscopic repair is safe and effective for the treatment of IBR. However, there are no contemporary guidelines on the application of laparoscopy for the management of EBR. Herein, we describe a case of combined EBR and IBR in a hemodynamically stable 45-year-old patient who sustained injuries after falling. Intravesical repair of EBR and intracorporeal repair of IBR with the bladder suspension method were successfully performed with laparoscopy. This is a rare case describing the feasibility of laparoscopic suturing for combined EBR and IBR in a patient with blunt trauma.
膀胱破裂通常是由腹部钝性创伤而非穿透性创伤引起的。腹膜内膀胱破裂（IBR）是手术治疗的明确指征。另一方面，外科医生仅在复杂病例中对腹膜外膀胱破裂（EBR）患者进行手术。非复杂性EBR采用保守治疗。腹腔镜修补术治疗IBR安全有效。然而，目前尚无关于腹腔镜在EBR治疗中应用的当代指南。在此，我们描述了一例45岁血流动力学稳定的患者，因跌倒受伤后出现EBR和IBR合并的病例。通过腹腔镜成功地对EBR进行了膀胱内修补，并采用膀胱悬吊法对IBR进行了体内修补。这是一例罕见病例，描述了在钝性创伤患者中腹腔镜缝合治疗EBR和IBR合并症的可行性。
