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经阴道非创伤性分娩后多产妇女自发性膀胱破裂:一例罕见病例报告

Spontaneous bladder rupture following non traumatic vaginal delivery in a multiparous woman: A rare case report.

作者信息

Ouafidi Btissam, Bouab Maryem, Kiram Hamza, Jalal Mohamed, Lamrissi Amine, Fichtali Karima, Bouhya Said

机构信息

Obstetrics and Gynecology Department, Univesity Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

Obstetrics and Gynecology Department, Univesity Hospital Center Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.

出版信息

Int J Surg Case Rep. 2021 Oct;87:106349. doi: 10.1016/j.ijscr.2021.106349. Epub 2021 Aug 27.

Abstract

INTRODUCTION

Spontaneous bladder rupture SBR is a rare condition and often missed diagnosis, especially after a nontraumatic vaginal delivery.

CASE PRESENTATION

A 34-year-old patient who had a nontraumatic vaginal delivery presented to the emergency room 7 days later with acute abdomen and anuria. Computed tomography showed free fluid in the peritoneal cavity. An intraperitoneal rupture of the bladder dome was detected, showing extravasation of contrast into the peritoneal cavity. An exploratory laparotomy revealed a perforation on the bladder dome that was sutured.

CLINICAL DISCUSSION

SBR following vaginal delivery is an extremely rare condition. It represents a surgical emergency. Due to the low incidence and the presence of non-specific symptoms, diagnosis was usually delayed with an increased morbidity and mortality. Clinicians should consider this diagnosis in the presence of an acute abdominal pain associated to anuria or dysuria. We therefore recommend that the bladder be catheterized or drained before labour.

CONCLUSION

SBR is a rare and life-threatening condition in post-partum. Abdominal pain with elevated serum creatinine should be suspicious of urinary bladder rupture.

摘要

引言

自发性膀胱破裂(SBR)是一种罕见的病症,常常漏诊,尤其是在非创伤性阴道分娩后。

病例报告

一名34岁的患者在非创伤性阴道分娩7天后因急腹症和无尿症就诊于急诊室。计算机断层扫描显示腹腔内有游离液体。检测到膀胱顶部腹膜内破裂,造影剂外渗至腹腔。剖腹探查发现膀胱顶部有穿孔并进行了缝合。

临床讨论

阴道分娩后发生的SBR是一种极其罕见的病症。它代表一种外科急症。由于发病率低且存在非特异性症状,诊断通常会延迟,发病率和死亡率会增加。临床医生在出现与无尿症或排尿困难相关的急性腹痛时应考虑这一诊断。因此,我们建议在分娩前对膀胱进行插管或引流。

结论

SBR是产后一种罕见且危及生命的病症。伴有血清肌酐升高的腹痛应怀疑膀胱破裂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6282/8450237/5164ed079b3c/gr1.jpg

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