Bladder incarceration following anterior external fixation of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

Finnan, Ryan; Herbenick, Michael A.; Prayson, Michael J.; McCarthy, Mary C.

doi:10.1186/1754-9493-2-26

Cited by 7 publications

(5 citation statements)

References 22 publications

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“…Herniation of the bladder through a symphyseal diastasis can occur due to injury to the supporting ligaments and pelvic fascia. Bladder entrapment may occur if closed reduction of symphyseal disruption is attempted 12 . Urethral injury is rare in females (<6%) due to its shorter length, internal location, increased elasticity, and less rigid attachment to the adjacent pubic bones 13 .…”

Section: Discussionmentioning

confidence: 99%

Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries

Goswami¹,

Kochhar²,

Suri

et al. 2012

J of Obstet and Gynaecol

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A 19-year-old woman presented with pelvic trauma following a road accident. She was hemodynamically stable. Examination revealed perineal injuries and type C pelvic fracture, which was stabilized with an external fixator. The broken ends of the pubic bone were brought together by an orthopedic wire. The detached vaginal wall and torn anal sphincter were surgically repaired after making a diverting colostomy. The postoperative period was uneventful. Colostomy was reversed after 3 months. Postoperatively the patient developed a cystocele, dyspareunia and vaginal pain. She conceived spontaneously and was planned for an elective cesarean at 37 weeks gestation; however, she presented in labor at 36 weeks and had a normal vaginal delivery. Pelvic fractures may be associated with genitourinary and anal sphincter injuries, which require management by a multidisciplinary team. On recovery the patient may develop prolapse, dyspareunia and persistent local pain. Spontaneous conception and normal vaginal delivery are nevertheless possible.

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Section: Discussionmentioning

confidence: 99%

Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries

Goswami¹,

Kochhar²,

Suri

et al. 2012

J of Obstet and Gynaecol

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“…As far as the authors are aware there are only 10 documented cases within the literature. [1] The majority of these cases are reported from an orthopaedic viewpoint with focus on pelvic rim management. The author presents a case of bladder incarceration in the setting of pubic diastasis managed conservatively.…”

Section: Discussionmentioning

confidence: 99%

Rare Case of Traumatic Bladder Herniation and Incarceration Managed Conservatively

2023

J Surg

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Pelvic fractures constitute a moderate proportion of blunt force traumas with known connection to genitourinary injuries. Injuries range from urethral injury, prostatic injury to complete bladder rupture. Bladder Herniation is a rare complication of pelvic trauma with only 10 cases documented in the literature with varying degrees of bladder damage. Bladder herniation and subsequent incarceration is typically associated with pubic diastasis and unstable pelvic fractures. Management has reportedly nearly always been operative intervention with pelvic fixation to reduce herniation. We report a case of significant bladder herniation secondary to pubic diastasis from a motor vehicle accident.

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“…This case report and those previously identified demonstrate that bladder entrapment in the fracture site is an additional mechanism of injury that must be appreciated. Bladder herniation and entrapment at the pubic symphysis after reduction of a traumatic diastasis has also been reported several times [9].…”

Section: Discussionmentioning

confidence: 99%

Entrapment of the urinary bladder: A rare mechanism of bladder injury in pelvic trauma

Stenquist

Chavez

Weaver

2019

Trauma Case Reports

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A pelvic fracture with entrapment of the urinary bladder in the fracture site is a rare pattern of injury. As the “team captains” in the trauma bay and in the care of polytraumatized patients, trauma surgeons must be aware of this entity and its implications. We report a case of acute bladder entrapment in the fracture site of a lateral compression pelvic fracture. A review of the English literature yielded four previous reports, including two patients with delayed diagnosis (Ghuman et al., 2014; Kumar et al., 1980; Wright and Taitsman, 1996; Min et al., 2010 [1–4]). Kumar and colleagues first documented bladder entrapment by a pelvic fracture in 1980 (Kumar et al., 1980 [2]). Ghuman et al. described a similar case treated with fixation of the pelvic fracture (Ghuman et al., 2014 [1]). Wright and colleagues treated a patient with bladder perforation due to entrapment diagnosed two weeks after a pelvic ring fracture (Wright and Taitsman, 1996 [3]). In this case the bladder injury was repaired, but internal fixation of the pelvis fracture was avoided due to fear of contamination. Finally, Min et al. documented a case of bladder entrapment and perforation presenting six months after non-operative management of a pelvic ring fracture. The female patient developed recurrent UTIs and dyspareunia, and imaging revealed fracture malunion with the bladder entrapped in the fracture site (Min et al., 2010 [4]). This collection of case reports demonstrates the potential for acute or delayed bladder injury even in seemingly benign pelvic fractures. A high index of suspicion is required to intervene and prevent morbidity from bladder injuries in pelvic trauma. Entrapment of the bladder may require surgical intervention even when the injury pattern would not normally dictate surgery for the pelvis or bladder alone (Bryk and Zhao, 2016 [5]). We describe the diagnosis and surgical management of bladder entrapment and present a brief review of bladder injuries associated with pelvic fractures.

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Bladder incarceration following anterior external fixation of a traumatic pubic symphysis diastasis treated with immediate open reduction and internal fixation

Cited by 7 publications

References 22 publications

Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries

Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries

Rare Case of Traumatic Bladder Herniation and Incarceration Managed Conservatively

Entrapment of the urinary bladder: A rare mechanism of bladder injury in pelvic trauma

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