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Dabbagh M, Maazouz A, Moujahid M, Bounaim A, Bouchentouf SM. Generalized Peritonitis Secondary to Spontaneous Rupture of the Urinary Bladder. Cureus 2024; 16:e60053. [PMID: 38854308 PMCID: PMC11162757 DOI: 10.7759/cureus.60053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2024] [Indexed: 06/11/2024] Open
Abstract
A spontaneous rupture of the urinary bladder (SRUB) is an exceedingly rare surgical emergency that might be misdiagnosed, resulting in a high mortality risk. Clinicians should be mindful that secondary peritonitis can occur as a result of a ruptured urinary bladder, which is frequently misdiagnosed and undertreated. The majority of cases are identified during laparotomy. We report a case of a 70-year-old woman who had irradiation for endometrial cancer 25 years ago and had a history of hypertension, diabetes, and recurring urinary tract infections. The current study sought to determine the etiology of SRUB as well as clinical aspects and diagnostic strategies. She was diagnosed with generalized peritonitis. An exploratory laparotomy discovered a perforated urinary bladder. Following further care, the patient was released with no further complaints.
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Affiliation(s)
- Mahmoud Dabbagh
- Department of Surgery, Mohammed V Military Training Hospital, Rabat, MAR
| | - Amine Maazouz
- Department of Surgery, Mohammed V Military Training Hospital, Rabat, MAR
| | | | - Ahmed Bounaim
- Department of Surgery, Mohammed V Military Training Hospital, Rabat, MAR
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Ficky, Wahyudi I, Widia F, Irdam GA. Challenges in the diagnosis of delayed presentation of intraperitoneal Iatrogenic bladder trauma post Caesarean delivery: A case report. Urol Case Rep 2024; 53:102679. [PMID: 38495850 PMCID: PMC10940946 DOI: 10.1016/j.eucr.2024.102679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 03/19/2024] Open
Abstract
Iatrogenic bladder trauma (IBT), a rare complication of Caesarean delivery (CD), can present with delayed symptoms, posing diagnostic challenges. A case study reports IBT presenting six days post-CD, initially undetected by retrograde cystography and CT urography. Subsequent surgical exploration revealed an 8-cm wound in the bladder dome, concealed by a hematoma and enlarged uterus. While retrograde cystography is typically accurate, false negatives may occur. CT cystography offers higher sensitivity but may still miss small perforations. Delayed IBT can manifest with abdominal pain, hematuria, and elevated renal function tests, warranting clinical suspicion and consideration of surgical exploration despite negative imaging.
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Affiliation(s)
- Ficky
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Irfan Wahyudi
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Fina Widia
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Gampo Alam Irdam
- Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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A series of unfortunate bladder events: An illustrative case series of a diverse cohort of bladder perforations. Radiol Case Rep 2022; 17:4139-4143. [PMID: 36105837 PMCID: PMC9465360 DOI: 10.1016/j.radcr.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022] Open
Abstract
Bladder perforation is a potentially life-threatening condition, typically occurring after genitourinary trauma. The vast majority of cases are secondary to blunt abdominal trauma resulting in pelvic fractures, with motor vehicle accidents the commonest cause. There are however a wide range of underlying causes, including iatrogenic injuries and spontaneous perforations. This case series of 4 unusual cases of bladder perforations presenting to a single center under the same consultant within a 3-month period aims to highlight the diverse nature of patients who can present with bladder perforations and the different management options available.
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Reddy R. Role of Ultrasonography in Intraperitoneal Bladder Rupture With Delayed Presentation. Cureus 2021; 13:e20159. [PMID: 35003988 PMCID: PMC8723773 DOI: 10.7759/cureus.20159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Abstract
Delayed presentation of intraperitoneal rupture of the urinary bladder in a child after blunt trauma is a rare occurrence. On ultrasonography, diagnosis of bladder injuries has been sparsely reported in the literature. We report a case of intraperitoneal bladder rupture in a four-year-old child and describe the role of ultrasonography in providing a prompt and accurate diagnosis of the entity as mortality increases if surgical repair is delayed. On high-resolution ultrasonography, rent was noted in the urinary bladder dome with fluid collection in the paracolic gutters and between loops of the small bowel. Peritoneocentesis demonstrated urine and the child was taken up for laparoscopic repair of the bladder tear, which was visualized at the bladder dome. Cystogram performed at one week was unremarkable and the post-operative period was uneventful with no complaints at a one-month follow-up.
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Inoguchi K, Hongo T, Naito H, Nakao A. A Rare Case of Pelvic Abscess Due to Spontaneous Non-traumatic Bladder Rupture. Cureus 2021; 13:e18913. [PMID: 34812299 PMCID: PMC8604095 DOI: 10.7759/cureus.18913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/05/2022] Open
Abstract
Spontaneous bladder rupture is an uncommon and life-threatening urological emergency, and early diagnosis is often challenging. Herein, we report a case of intraperitoneal bladder rupture in an 81-year-old male with neurogenic bladder-the case of intraperitoneal bladder rupture required late laparotomy for pelvic abscess following initial conservative treatment. An eighty-one-year-old male presented to our emergency department with deterioration of consciousness, fever, and hematuria. He denied previous trauma history and had been treated for neurogenic bladder. Physical examination revealed signs of tenderness in the abdomen. A diagnosis of bladder rupture was made based on laboratory examination indicating renal failure and radiological imaging showing urinary ascites. Conservative management with a Foley catheter and antibiotics (meropenem administered 1 g/day) was initiated. On day seven after admission, the patient complained of abdominal pain and fever, and a diagnosis of pelvic abscess based on contrast-enhanced computed tomography and septic peritonitis was made. An emergency exploratory laparotomy for peritoneal drainage was performed. The postoperative course was uneventful, and the patient was discharged on day 29 after admission. Urinary bladder rupture should always be considered as a differential diagnosis in patients presenting with free fluid in the abdomen, peritonitis, reduced urine output, and hematuria. Clinicians should be aware that secondary bacterial peritonitis can occur as a major complication of a ruptured urinary bladder.
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Affiliation(s)
- Kyosuke Inoguchi
- Emergency Department, Okayama Saiseikai General Hospital, Okayama, JPN
| | - Takashi Hongo
- Emergency Department, Okayama Saiseikai General Hospital, Okayama, JPN.,Emergency, Critical Care, and Disaster, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Hiromichi Naito
- Emergency, Critical Care, and Disaster, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JPN
| | - Atsunori Nakao
- Emergency, Critical Care and Disaster, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, JPN
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A Complex Case of Emphysematous Cystitis in a Peritoneal Dialysis Patient. Case Rep Nephrol 2021; 2021:8343022. [PMID: 34306777 PMCID: PMC8282390 DOI: 10.1155/2021/8343022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022] Open
Abstract
Emphysematous cystitis (EC) is a relatively rare condition characterized by gas formation in the bladder wall and/or lumen. We report a case of emphysematous cystitis with a bladder perforation in an 84-year-old male on peritoneal dialysis who presented with fever, dysuria, hematuria, and hypotension. Gas in the bladder wall, as well as a small perforation in the roof of the urinary bladder, was seen on the abdominal CT scan. The causative organism identified was Escherichia coli. The patient recovered with broad-spectrum antibiotics along with bladder irrigation and drainage. After initial bladder washouts, peritoneal dialysis was continued with close monitoring. Early antibiotic therapy and a conservative approach to the management of small intraperitoneal bladder perforations were effective in this patient. Peritoneal dialysis was uninterrupted for the duration of the admission and after discharge.
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Albukhari SN, Khawaji A, Azhar RA. Non-Operative Management of Iatrogenic Intraperitoneal Bladder Injury Following a Cesarean Section. Cureus 2021; 13:e13150. [PMID: 33692920 PMCID: PMC7937351 DOI: 10.7759/cureus.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Iatrogenic bladder injuries with intraperitoneal extravasations are standardly managed surgically. However, we are presenting a case of iatrogenic intraperitoneal bladder injury developing after a cesarean section that was managed successfully by conservative therapy after tapping and pigtail drainage of 14 days. On the next follow up, which was 14 days later, there was a complete resolution with no signs of injury. Therefore, the trial of conservative approach may prove beneficial to minimize the chances of any invasive interventions in such cases.
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Affiliation(s)
- Saeed N Albukhari
- Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Raed A Azhar
- Urology, International Medical Centre, King Abdulaziz University, Jeddah, SAU
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Alahmadi M, Ghazi AA. Case reported for iatrogenic cystectomy during cesarean delivery. Urol Case Rep 2020; 31:101180. [PMID: 32382507 PMCID: PMC7200233 DOI: 10.1016/j.eucr.2020.101180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 03/28/2020] [Indexed: 11/24/2022] Open
Abstract
Although bladder injury is a rare complication during cesarean delivery (CD), its incidence is increasing due to the growing trend in elective CD. Herein, we report a case of a 28-year-old woman, who presented during labor. An emergency CD and hysterectomy were done to control bleeding. The case was complicated by and inadvertent cystectomy. Urine was diverted immediately by ureterostomy. After five months, augmentation ileocytoplasty, bilateral ureteral re-implantation, and abdominal catheterizable stoma formation were carried out. This case highlights the surgical management of inadvertent cystectomy during CD.
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