1
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Zhang Z, Shen J, He Q, Nie H. Spontaneous rupture of bladder diverticulum with pseudo renal failure:A case report and literature review. Am J Emerg Med 2024; 79:231.e3-231.e7. [PMID: 38508995 DOI: 10.1016/j.ajem.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Spontaneous or non-traumatic bladder rupture is rare but can be life-threatening. Bladder rupture caused by a diverticulum is extremely rare, with only a few case reports in medical literature. CASE PRESENTATION We report the case of a 32-year-old woman admitted to hospital complaints of abdominal pain, oliguria and ascites with no history of trauma. Laboratory tests revealed an elevated serum urea nitrogen(UN) level of 33.5 mmol/l and an elevated creatinine levels of 528 umol/l. X-ray cystography confirmed the rupture of a bladder diverticulum. Subsequent transurethral catheterization led to a prompt increase in urinary output, and serum creatinine level returned to 40 umol/l within 48 h. The patient was successfully treated with laparoscopic diverticulectomy. CONCLUSION Clinicians should maintain a high level of suspicion for urinary bladder rupture in cases presenting with acute lower abdominal pain, urinary difficulties, and oliguria. When acute renal failure, complicated ascites, and an elevated peritoneal fluid creatinine or potassium level exceeding serum levels are observed, intraperitoneal urine leakage should be suspected without delay. This case emphasizes the importance of early diagnosis and intervention in managing this rare but serious condition.
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Affiliation(s)
- Zhuo Zhang
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Jing Shen
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qian He
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hu Nie
- Department of Emergency Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China; West China Xiamen Hospital of Sichuan University, Xiamen, Fujian, China.
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2
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Foura S, Fouraiji K, Aballa N, Kamili EOELA, Saiad MO. Iatrogenic Rupture of the Urinary Bladder in an Infant During Retrograde Cystourethrography. Afr J Paediatr Surg 2024; 21:61-63. [PMID: 38259023 PMCID: PMC10903736 DOI: 10.4103/ajps.ajps_49_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 08/24/2022] [Accepted: 10/10/2022] [Indexed: 01/22/2023] Open
Abstract
ABSTRACT Iatrogenic bladder rupture in children during a retrograde cystourethrography is very uncommon. We present a case of iatrogenic intraperitoneal bladder rupture in a 9-month child during the retrograde cystourethrography performed by a radiologist. The child presented in a paediatric emergency after 6 h with an acute abdomen indicating urinary peritonitis. An urgent laparotomy was performed and the perforation was repaired in two layers. The follow-up was unremarkable. This report emphasises the importance of respecting the criteria of the proper retrograde cystourethrography imaging procedure.
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Affiliation(s)
- Salma Foura
- Department of Pediatric Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
| | - Karima Fouraiji
- Department of Pediatric Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
| | - Najoua Aballa
- Department of Pediatric Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
| | - El Ouafi EL Aouni Kamili
- Department of Pediatric Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
| | - Mohamed Oulad Saiad
- Department of Pediatric Surgery, Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakech, Morocco
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3
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Jiang R, Huang Y, Zeng M, Xing C, Mao H, Wu B. A marked elevation in serum creatinine/cystatin C ratio may indicate pseudo-acute kidney injury due to urinary ascites: a case report and literature review. BMC Nephrol 2023; 24:243. [PMID: 37605159 PMCID: PMC10441709 DOI: 10.1186/s12882-023-03289-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Urinary ascites represents a scarcely observed pseudo-acute kidney injury in clinical settings. Protracted or missed diagnosis may hold grave ramifications for patient outcomes. CASE PRESENTATION We reported a case involving an elderly female patient experiencing pseudo-acute kidney injury accompanied by ascites, wherein her renal dysfunction persisted despite medical intervention and hemodialysis. Urinary ascites was identified via a methylene blue test and by contrasting creatinine levels in serum and ascites. This patient's kidney function was multiple typified by a marked elevation in serum creatinine/Cystatin C ratio (> 2 L/dL), potentially serving as a clue for the clinical diagnosis of pseudo-acute kidney injury engendered by urinary ascites. CONCLUSIONS This case suggested the potential diagnostic value of an asynchronous increase in serum creatinine and serum CysC (or an increased ratio of blood creatinine to blood CysC) in patients with pseudo-acute kidney injury.
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Affiliation(s)
- Ran Jiang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yumin Huang
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Ming Zeng
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Changying Xing
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Huijuan Mao
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Buyun Wu
- Department of Nephrology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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4
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Badheeb A, Alkhanbashi O, Rakrouki S, Mahmood T, Alqannas M, Badheeb M, Ahmed F. Bladder rupture after pembrolizumab immunotherapy for bladder cancer: a case report. Pan Afr Med J 2022; 42:98. [PMID: 36034031 PMCID: PMC9379440 DOI: 10.11604/pamj.2022.42.98.33911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/01/2022] [Indexed: 12/28/2022] Open
Abstract
Pembrolizumab is a promising checkpoint inhibitor for advanced urothelial carcinoma. Like other immunotherapies, it can cause rare immune-related adverse events. The spontaneous rupture of the urinary bladder after the intravenous injection of pembrolizumab is rare and has not been reported. Here, we present a 74-year-old man patient case of locally advanced transitional cell carcinoma of the urinary bladder who presented severe abdominal pain the same day of the second dose of pembrolizumab administration. The exploratory laparotomy revealed intraperitoneal rupture of the urinary bladder associated with peritonitis. After surgical repair, the patient's condition improved. The purpose of this report is to discuss the possible association of bladder perforation in bladder cancer with pembrolizumab immunotherapy, its management, and the importance of early recognition to prevent more fatal complications.
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Affiliation(s)
- Ahmed Badheeb
- Oncology Center, King Khalid Hospital, Najran, Saudi Arabia
| | - Omar Alkhanbashi
- Department of Urology, King Khalid Hospital, Najran, Saudi Arabia
| | - Slah Rakrouki
- Department of Urology, King Khalid Hospital, Najran, Saudi Arabia
| | - Tahir Mahmood
- Department of General Surgery, King Khalid Hospital, Najran, Saudi Arabia
| | - Mashhoor Alqannas
- Department of General Surgery, King Khalid Hospital, Najran, Saudi Arabia
| | - Mohamed Badheeb
- Department of Internal Medicine, King Khalid Hospital, Najran, Saudi Arabia
| | - Faisal Ahmed
- Urology Research Center, Al-Thora General Hospital, Department of Urology, School of Medicine, Ibb University of Medical Science, Ibb, Yemen
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5
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Colombo G, Furlan L, Mucci F, Zannoni S, Andrisani MC, Solbiati M. Ascites, abdominal pain, and acute renal failure in a middle-aged woman. Intern Emerg Med 2020; 15:299-302. [PMID: 30806894 DOI: 10.1007/s11739-019-02054-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 02/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Giorgio Colombo
- Dipartimento di Medicina Interna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122, Milan, Italy.
| | - Ludovico Furlan
- Dipartimento di Medicina Interna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122, Milan, Italy
| | - Francesco Mucci
- Dipartimento di Medicina Interna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via Francesco Sforza 35, 20122, Milan, Italy
| | - Stefania Zannoni
- Dipartimento di Radiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Carmela Andrisani
- Dipartimento di Radiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Monica Solbiati
- UOC Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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6
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Olanipekun T, Effoe V, Turner J, Flood M. Bladder necrosis and perforation in end-stage renal disease and recurrent urinary tract infection: A rare medical emergency. Int J Crit Illn Inj Sci 2019; 9:101-104. [PMID: 31334054 PMCID: PMC6625330 DOI: 10.4103/ijciis.ijciis_72_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Bladder necrosis and perforation is a rare and life-threatening medical emergency. Risk factors include trauma, malignancy, previous surgery and/or radiation therapy and diabetes mellitus. Signs, symptoms, and imaging findings are often obscure making the diagnosis difficult. Urinary tract infection is common in end-stage renal disease (ESRD) patients who have residual urine production and associated with increased complication and mortality rates. We describe the case of a 57-year-old female with a medical history of recurrent cystitis, type 2 diabetes mellitus and ESRD on hemodialysis that was admitted for septic shock and presumed ischemic colitis. Urine and blood microbiology studies were notable for Escherichia coli. By the second day of hospital admission, her clinical condition significantly deteriorated and was later found to have bladder necrosis and rupture during laparotomy for suspected peritonitis. It is important that clinicians recognize bladder rupture as a potential complication of recurrent bacterial cystitis in ESRD patients on dialysis.
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Affiliation(s)
- Titilope Olanipekun
- Department of Internal Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.,Department of Gastroenterology, Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Valery Effoe
- Department of Internal Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.,Department of Gastroenterology, Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Jacqueline Turner
- Department of Colorectal Surgery, Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
| | - Michael Flood
- Department of Gastroenterology, Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA.,Department of Colorectal Surgery, Morehouse School of Medicine, Grady Memorial Hospital, Atlanta, Georgia, USA
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7
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Chien-Hua C, Yun-Te C, Neng-Chyan H, Fong-Dee H. New-Onset Massive Ascites With Acute Kidney Injury Due to Spontaneous Rupture of the Urinary Bladder. J Acute Med 2019; 9:64-68. [PMID: 32995233 PMCID: PMC7440379 DOI: 10.6705/j.jacme.201906_9(2).0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Spontaneous rupture of the urinary bladder (SRUB) is a rare urological emergency associated with urinary ascites and apparent acute kidney injury. The clinical course can be severe or lethal if no early diagnosis is achieved. We present a 44-year-old woman with type 2 diabetes mellitus had progressive abdominal fullness, poor appetite, dyspnea, and lower legs edema for two days. Laboratory studies present as acute kidney injury. Abdominal sonogram and computed tomogram (CT) revealed massive ascites. Her ascitesrelieved dramatically after Foley catheter indwelling, and daily urine amount was about 5,000 mL. Urinary bladder rupture was found after CT cystography. She received surgical repair of the ruptured urinary bladder, and cystometry revealed detrusor arefl exia. Then she was discharged uneventfully.
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Affiliation(s)
- Chen Chien-Hua
- Chiayi Branch, Taichung Veterans General HospitalDepartment of Emergency MedicineChiayiTaiwan,Kaohsiung Veterans General HospitalDepartment of Emergency MedicineNo. 386, Ta-Chung 1st Rd.Kaohsiung813Taiwan
| | - Chang Yun-Te
- Kaohsiung Veterans General HospitalDepartment of Emergency MedicineNo. 386, Ta-Chung 1st Rd.Kaohsiung813Taiwan
| | - Huang Neng-Chyan
- Kaohsiung Veterans General HospitalDepartment of Emergency MedicineNo. 386, Ta-Chung 1st Rd.Kaohsiung813Taiwan
| | - Huang Fong-Dee
- Kaohsiung Veterans General HospitalDepartment of Emergency MedicineNo. 386, Ta-Chung 1st Rd.Kaohsiung813Taiwan
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8
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Abstract
Deaths due to hemoperitoneum are not rare and can result from a variety of underlying pathologic processes, including natural disease as well as trauma. Whenever hemoperitoneum is identified at autopsy, it is incumbent upon the pathologist to identify the source of the hemorrhage. The authors present a case of probable traumatic rupture of the urinary bladder that resulted in lethal intra-abdominal hemorrhage, occurring in a young man who was found dead the morning after drinking heavily.
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Affiliation(s)
- Thu Nguyen
- Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA
| | - Joseph A Prahlow
- Western Michigan University Homer Stryker M.D. School of Medicine, 300 Portage St., Kalamazoo, MI, 49007, USA.
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9
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Palthe S, Dijkstra GA, Steffens MG. A case of spontaneous urinary bladder rupture secondary to urinary retention due to an urethral stricture. Urol Case Rep 2018. [PMID: 29541588 PMCID: PMC5849873 DOI: 10.1016/j.eucr.2018.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A spontaneous, non-traumatic, urinary bladder rupture is a rare condition. We describe a case of a 23-year-old male with a spontaneous bladder rupture secondary to urinary retention, due to an urethral stricture. He presented to the emergency department with voiding difficulties, severe abdominal pain and renal failure. Abdominal ultrasound revealed large amounts of ascites. After an unsuccessful attempt to place a Foley catheter a cystoscopy was performed which showed an urethral stricture. On CT-cystogram an intra-peritoneal bladder rupture was diagnosed and the patient underwent laparoscopic repair of the bladder wall. The postoperative course was uneventful.
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Affiliation(s)
- S Palthe
- Department of Urology, Isala, PO Box 10400, 8000 GK Zwolle, The Netherlands
| | - G A Dijkstra
- Department of Urology, Isala, PO Box 10400, 8000 GK Zwolle, The Netherlands
| | - M G Steffens
- Department of Urology, Isala, PO Box 10400, 8000 GK Zwolle, The Netherlands
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10
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Taniguchi K, Iida R, Ota K, Nitta M, Tsujino T, Komura K, Inamoto T, Azuma H, Uchiyama K, Takasu A. Spontaneous rupture of the urinary bladder (SRUB): Recovery from cardiopulmonary arrest. Am J Emerg Med 2017; 35:1584.e5-1584.e7. [PMID: 28751042 DOI: 10.1016/j.ajem.2017.07.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 07/16/2017] [Indexed: 11/25/2022] Open
Abstract
Spontaneous rupture of the urinary bladder (SRUB) is rare and results in a lethal condition, i.e., pan peritonitis. However, early and accurate diagnosis of SRUB is very difficult. A 54-year-old woman was transported to our hospital with suspicion of pan peritonitis after spontaneous return of circulation with pulseless electrical activity. Laboratory investigation seemed to indicate acute renal failure. Namely, her serum urea and creatinine levels were grossly elevated. Exploratory laparotomy showed unexpected rupture of urinary bladder. Her recovery after surgery was relatively smooth. SRUB should be considered in the differential diagnosis of pan peritonitis, because urgent appropriate surgical intervention can rescue patients from this rare lethal disease.
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Affiliation(s)
- Kohei Taniguchi
- Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan; Department of General and Gastroenterological Surgery, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
| | - Ryo Iida
- Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan; Department of General and Gastroenterological Surgery, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Koshi Ota
- Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Masahiko Nitta
- Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Takuya Tsujino
- Department of Urology, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Kazumasa Komura
- Department of Urology, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Teruo Inamoto
- Department of Urology, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Haruhito Azuma
- Department of Urology, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Kazuhisa Uchiyama
- Department of General and Gastroenterological Surgery, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
| | - Akira Takasu
- Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan
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11
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Spontaneous Bladder Rupture Masquerading as Pseudo-diverticulum. Urol Case Rep 2017; 12:73-75. [PMID: 28377891 PMCID: PMC5377291 DOI: 10.1016/j.eucr.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
Spontaneous bladder rupture is rare. Presentation is non-specific and in absence of history of trauma, radiation, inflammatory conditions and other leading causes, there is considerable diagnostic delay. Absence of clear cut diagnostic signs leads to increased morbidity and mortality. In many patients, omentum seals perforation, giving diverticular appearance in Cystogram. The objective of this case report is to highlight important specific diagnostic points in history and radiology which will help in clear, early diagnosis and treatment causing immense benefit to the patient. We would also like to highlight a specific radiological point to distinguish true from pseudo-diverticulum.
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12
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Kivlin D, Ross C, Lester K, Metro M, Ginsberg P. A Case Series of Spontaneous Rupture of the Urinary Bladder. Curr Urol 2015; 8:53-6. [PMID: 26195965 PMCID: PMC4483303 DOI: 10.1159/000365690] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022] Open
Abstract
We report 2 cases of spontaneous bladder rupture related to chronic outlet obstruction and urinary retention. In both cases, focal perforation was identified within diverticula. Bladder rupture in the absence of trauma is a rare and serious event with a mortality rate approaching 50%. These injuries are often initially misdiagnosed and it is our goal to provide insight to the presentation, management and treatment of this rare event.
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Affiliation(s)
- Dana Kivlin
- Department of Urology, Einstein Health Care Network, Philadelphia, Pa., USA
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13
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Shin JY, Yoon SM, Choi HJ, Lee SN, Kim HB, Joo WC, Song JH, Kim MJ, Lee SW. A Case of Post-radiotherapy Urethral Stricture with Spontaneous Bladder Rupture, Mimicking Obstructive Uropathy due to Cancer Metastasis. Electrolyte Blood Press 2014; 12:26-9. [PMID: 25061470 PMCID: PMC4105386 DOI: 10.5049/ebp.2014.12.1.26] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 04/10/2014] [Indexed: 11/19/2022] Open
Abstract
Non-traumatic, spontaneous urinary bladder rupture is a rare complication of urethral stricture. Furthermore, its symptoms are often nonspecific, and misdiagnosis is common. The authors experienced a case of urethral stricture with spontaneous bladder rupture and bilateral hydronephrosis, mimicking obstructive uropathy attributed to cancer metastasis. A 55-year-old woman was admitted with abdominal pain and distension, oliguria, and an elevated serum creatinine level. She had undergone radical hysterectomy for uterine cervical cancer and received post-operative concurrent chemoradiation therapy 13 years previously. Non-contrast enhanced computed tomography showed massive ascites and bilateral hydronephrosis. The initial diagnosis was acute kidney injury due to obstructive uropathy caused by malignant disease. After improvement of her renal function by bilateral percutaneous nephrostomy catheterization, contrast-enhanced computed tomography and a cytologic examination of ascites showed no evidence of malignancy. However, during retrograde pyelography, a severe urethral stricture was found, and subsequent cystography showed leakage of contrast into the peritoneal cavity and cystoscopy revealed a defect of the posterior bladder wall. After urethral dilatation and primary closure of the bladder wall, acute kidney injury and ascites were resolved.
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Affiliation(s)
- Jun Young Shin
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Sang Min Yoon
- Department of Urology, Inha University College of Medicine, Incheon, Korea
| | - Hyuck Jae Choi
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Si Nae Lee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hai Bong Kim
- Division of Nephrology, Department of Internal Medicine, Yanbian University Hospital, Yanji, Jilin Province, China
| | - Woo Chul Joo
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Joon Ho Song
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Moon-Jae Kim
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Seoung Woo Lee
- Division of Nephrology and Hypertension, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
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14
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R S, Barad AK, Ghalige HS, K S, Sharma M B. Perineal bull gore with urinary bladder perforation and pneumoperitoneum. J Clin Diagn Res 2013; 7:902-4. [PMID: 23814738 DOI: 10.7860/jcdr/2013/5556.2981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 02/20/2013] [Indexed: 11/24/2022]
Abstract
Animal related injuries are frequently reported in India and other countries, where bulls are used for sporting events as well as in places where farming and livestock rearing is practised. The presentation is, many times, atypical and misleading as well. They have unique mechanics of injury. The patterns of the injury are reviewed. An intra-peritoneal urinary bladder injury which is caused by a perineal bull gore with a pneumoperitoneum is unusual and it has not been reported in the literature which was reviewed. We are reporting a successfully treated 25 years old male patient from the slopes of the southern district of Manipur, India, who had presented 40 hours after he was injured. The identification and prompt exploration, keeping in mind the mechanics of bull goring, helps the surgeons to adequately deal such atypical injuries, for optimal outcomes.
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