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老年患者低能量骨盆骨折后的膀胱损伤与尿路感染

Bladder Injury and Urinary Tract Infection Following Low-Energy Pelvic Fracture in an Elderly Patient.

作者信息

Kataoka Yuki, Oniwa-Irie Mariko, Miyagawa Takuya

机构信息

Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Kyoto, JPN.

Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JPN.

出版信息

Cureus. 2024 Dec 27;16(12):e76482. doi: 10.7759/cureus.76482. eCollection 2024 Dec.

Abstract

This case report presents an 86-year-old female patient who developed a urinary tract injury and infection following a pelvic fracture caused by a bedside fall during hospitalization for  pneumonia. The patient experienced fever with chills and rigors, prompting antibiotic treatment. Imaging revealed an ischial tuberosity fracture with potential bone fragment retention in the bladder wall. Despite these complications, the patient was successfully treated with conservative management, including targeted antibiotic therapy, without surgical intervention. This case highlights the importance of considering urinary tract infections in elderly patients with pelvic fractures, even from low-energy trauma. Conservative treatment can be effective in managing extraperitoneal bladder injuries and associated infections, even in the presence of bone fragments. The successful outcome indicates that surgical intervention may not always be necessary when infection control is achieved through conservative measures.

摘要

本病例报告介绍了一名86岁女性患者,该患者因肺炎住院期间在床边跌倒导致骨盆骨折,进而发生尿路损伤和感染。患者出现发热、寒战和恶寒,遂接受抗生素治疗。影像学检查显示坐骨结节骨折,膀胱壁可能残留骨碎片。尽管出现了这些并发症,但患者通过保守治疗成功康复,包括针对性的抗生素治疗,未进行手术干预。本病例强调了在老年骨盆骨折患者中,即使是低能量创伤,也要考虑尿路感染的重要性。保守治疗对于管理腹膜外膀胱损伤及相关感染可能有效,即使存在骨碎片。成功的治疗结果表明,当通过保守措施实现感染控制时,手术干预可能并非总是必要的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b8d/11769577/873c0e084745/cureus-0016-00000076482-i01.jpg

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