Nah Sangun, Choi Sungwoo, Kim Woong Bin, Han Sangsoo
J Emerg Nurs. 2025 Jun 23. doi: 10.1016/j.jen.2025.05.011.
Iatrogenic bladder rupture is a rare but potentially life-threatening complication. Bladder rupture resulting from the insertion of a urinary catheter is exceedingly uncommon. Here, we report a case of bladder rupture after urinary catheter insertion in a patient with bladder cancer.
An 80-year-old woman presented to the emergency department with fever, flank pain, and difficulty urinating. Her medical history included bladder cancer and neurogenic bladder. A urinary catheter had been placed owing to recent worsening of bladder function and had been maintained for 10 days. It was removed at an outpatient urology clinic the day before her emergency department visit to prevent a urinary tract infection. However, due to urinary retention, the urinary catheter was reinserted in the emergency department. After insertion, she complained of acute abdominal pain. Computed tomography revealed an intraperitoneal bladder rupture, with the urinary catheter positioned extraluminally through the bladder dome. The catheter was repositioned under ultrasound guidance, and conservative management with broad-spectrum antibiotics was initiated. The patient recovered well and was discharged without complications after 3 weeks.
Urinary catheterization in patients at high risk of bladder rupture should be performed with careful technique, and the use of ultrasound guidance may be considered to minimize the risk of injury and ensure proper catheter placement.
医源性膀胱破裂是一种罕见但可能危及生命的并发症。因插入导尿管导致的膀胱破裂极为罕见。在此，我们报告一例膀胱癌患者在插入导尿管后发生膀胱破裂的病例。
一名80岁女性因发热、胁腹痛和排尿困难就诊于急诊科。她的病史包括膀胱癌和神经源性膀胱。由于近期膀胱功能恶化放置了导尿管，并维持了10天。在她前往急诊科就诊的前一天，在门诊泌尿外科诊所将其拔除以预防尿路感染。然而，由于尿潴留，在急诊科重新插入了导尿管。插入后，她主诉急性腹痛。计算机断层扫描显示腹膜内膀胱破裂，导尿管经膀胱穹窿位于管腔外。在超声引导下重新放置导尿管，并开始使用广谱抗生素进行保守治疗。患者恢复良好，3周后无并发症出院。
对于膀胱破裂高危患者，导尿操作应技术谨慎，可考虑使用超声引导以将损伤风险降至最低并确保导尿管正确放置。
