Department of Anesthesiology and Intensive Care, Hedi Chaker University Hospital, Sfax, Tunisia.
Department of Gynecology and Obstetrics, Hedi Chaker University Hospital, Sfax, Tunisia.
Pan Afr Med J. 2023 Jan 12;44:22. doi: 10.11604/pamj.2023.44.22.33702. eCollection 2023.
Spontaneous bladder rupture (SBR) is a rare condition and often missed diagnosis, especially after a non traumatic vaginal delivery. A 32-year-old para 3 woman, consulted for abdominal pain and anuria two days after instrumental vaginal delivery with forceps for foetal distress in second sate of labour. Blood tests were suggestive of an acute renal failure. An abdominocentesis revealed a clear fluid looking like ascites. The ultrasound and computed tomography (CT) scan showed a large abdominal effusion. An exploratory laparoscopy revealed a bladder perforation which was sutured after laparotomy. SRB is extremely rare after a non traumatic vaginal delivery. It is associated with significant morbidity and mortality. Symptoms are mostly non-specific. It is suspected when post partum abdominal pain is associated with an effusion and renal failure signs. If suspected, the uroscanner remains the gold standard for diagnostic. Laparotomy is the standard surgical approach in this condition. Abdominal pain with elevated serum creatinine should be suspicious of SBR in post-partum.
自发性膀胱破裂（SBR）是一种罕见的疾病，常常被漏诊，尤其是在非创伤性阴道分娩后。一位 32 岁的经产妇，在第二产程因胎儿窘迫使用产钳行器械性阴道分娩后两天，因腹痛和无尿就诊。血液检查提示急性肾衰竭。腹腔穿刺抽出清亮液体，外观像腹水。超声和 CT 扫描显示大量腹腔积液。腹腔镜探查发现膀胱穿孔，行剖腹手术后进行缝合。SBR 在非创伤性阴道分娩后极为罕见。它与显著的发病率和死亡率相关。症状大多是非特异性的。当产后腹痛伴有积液和肾功能衰竭迹象时，应怀疑为 SBR。如果怀疑，尿路扫描仪仍然是诊断的金标准。剖腹探查是这种情况下的标准手术方法。产后出现腹痛伴血清肌酐升高应怀疑 SBR。
