Williams J C, Heaney J A, Young W
Department of Surgery, Dartmouth-Hitchock Medical Center, Lebanon, New Hampshire.
Urology. 1994 Sep;44(3):441-3. doi: 10.1016/s0090-4295(94)80113-4.
A case documenting the development of massive urinary ascites with associated pleural effusions and respiratory compromise due to an unrecognized cystotomy at the time of a tertiary low-vertical cesarean section is reported. The diagnosis was supported by elevated levels of serum blood urea nitrogen and creatinine and a peritoneal fluid to plasma creatinine ratio of 3:1. Imaging studies confirmed urinary extravasation into the peritoneum as well as bilateral pleural effusions and ascites. Primary intervention was to improve the patient's respiratory status and then to surgically repair the bladder wound.
本文报告了一例在第三次低位垂直剖宫产时因未识别的膀胱切开术导致大量尿腹水伴胸腔积液和呼吸功能不全的病例。血清血尿素氮和肌酐水平升高以及腹水与血浆肌酐比值为3:1支持了诊断。影像学研究证实尿液外渗至腹膜以及双侧胸腔积液和腹水。首要干预措施是改善患者的呼吸状况，然后手术修复膀胱伤口。
