Diagnosis and management of bladder injury by trauma surgeons

Hsieh, Chieh; Chen, Ray Jade; Fang, Ji‐Tseng; Lin, Being-Chuan; Hsu, Yung‐Heng; Kao, Jung Liang; Kao, Yi Chin; Yu, Po Chin; Kang, Shih‐Ching

doi:10.1016/s0002-9610(02)00913-3

Cited by 80 publications

(49 citation statements)

References 11 publications

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“…Conventional abdominal non-contrast CT has an accuracy rate of only 60.6% for bladder injury compared to 95.9% for the retrograde cystogram [12]. However, in a patient with worsening abdominal pain/distention and vital sign abnormalities, a CT scan will likely be the imaging modality of choice.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of Urinary Bladder in a Young Alcoholic Male

et al. 2016

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Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. We report this young male who presented with SRUB which occurred after alcohol intoxication and presented to us with vague abdominal pain, anuria, and intraperitoneal fluid collection. He had presented with a painful urinary retention few days prior to this visit, was catheterized temporarily and was discharged on antibiotics with a diagnosis of prostatitis. Currently, he stated that he had not urinated since the recent discharge, and noticed increasing abdominal distension. He also had diffuse severe abdominal pain. Patient stated that prior to this, he had consumed 12 beers. Examination revealed a male in acute distress, with normal ranges vital signs. Abdomen was soft, diffusely tender, with sluggish bowel-sounds, and no rebound-tenderness. Rest of examination was normal. Blood workup was significant for elevated BUN and creatinine from his baseline, and leukocytosis. A Foley catheter was placed. His abdomen computed tomography (CT) scan showed a newly developed pneumoperitoneum. CT cysto-urethrogram confirmed intraperitoneal bladder rupture. The patient had an exploratory laparotomy. The bladder defect was closed, and an indwelling catheter was left to ease healing. He had an uneventful postoperative course, and was discharged with a follow-up appointment in the urology clinic. Spontaneous urinary-bladder rupture is a rare event. Excessive alcohol consumption causes diuresis, over-distension and rupture of the urinary bladder. Initial presentation remains imprecise; continuous urinary leakage leads to abscesses, sepsis, and metabolic derangements. CT scan is imaging modality of choice. The condition is a surgical emergency, and necessitates laparotomy and closure of the breach.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of Urinary Bladder in a Young Alcoholic Male

et al. 2016

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“…Once passed, the presence of blood in the urine may indicate a bladder injury, and a cystogram should be performed [18,19].…”

Section: Discussionmentioning

confidence: 99%

Orthopedic Approach to the Early Management of Pelvic Injuries

Weaver

Heng

2015

Curr Trauma Rep

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High-energy pelvic fractures in trauma patients cause significant morbidity and mortality. A systematic approach to the early evaluation and management of these patients leads to improved outcomes. The initial care of patients with a displaced pelvic fracture and hemodynamic instability should focus upon three areas: 1) resuscitation, 2) bony stability, and 3) hemorrhage control. Aggressive resuscitation with blood products and clotting factors is paramount. The initial reduction of the pelvic ring and temporary stabilization can be achieved through the use of pelvic sheeting or binder placed in the field or trauma bay. Urgent surgical stabilization with external or internal fixation is often required. Hemorrhage control can be achieved through pelvic packing and/or angioembolization. The initial management of displaced pelvic fractures is multidisciplinary and should involve close collaboration between trauma surgery, orthopedic surgery, anesthesia, and interventional radiology.

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“…Savaşlarda mesane yaralanması, en sık penetran travmaların sonucu olarak ortaya çıkar ve bunu takiben pelvik kırıklarla ilişkili künt travmalar sonucu ortaya çıkar (43,44) . Bununla birlikte, künt travmaların mesaneye zarar vermesi sivil yaşamda savaş alanına göre daha yaygındır (44) .…”

Section: Mesane Yaralanmalarıunclassified

“…Bununla birlikte, künt travmaların mesaneye zarar vermesi sivil yaşamda savaş alanına göre daha yaygındır (44) . Savaş alanında penetran travmaya maruz kalan hastalar, eksplore edilmekte ve hem ekstraperitoneal hem de intraperitoneal yaralanmaları derhal onarılmaktadır.…”

Section: Mesane Yaralanmalarıunclassified

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

Değirmentepe¹,

Polat²,

Ötünçtemur³

2017

Okmeydani Medical Journal

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ÖZ GİRİŞÜriner sistemin organları, idrar oluşturma (böbrek), idrar iletme (üreterler ve üretra) veya idrar depolamaya (mesane) dayalı olarak vücudun diğer katı ve içi boş organlarından farklıdır (1) . Genitoüriner sistem travmaları tüm travma olgularının %10'unu oluştur-masına rağmen, önemli bir konudur (2) . Künt karın yaralanması denildiğinde ne tür nesne ile oluşursa oluşsun karın duvarı bütünlüğü bozulmaksızın karın içi organlarda yaralanma oluşturan travma anlaşılır. Künt yaralanmalar genellikle motorlu araç kazaları, yüksekten düşme ve şiddet içeren saldırılar sonucu meydana gelir. Künt travmaların en sık nedeni trafik kazalarıdır. Hareket halinde ani yavaşlamalar veya alınan darbeye bağlı ezilmeler organlarda yırtılma veya kontüzyon ile sonuçlanabilir (2) . Penetran travmada karın duvar bütünlüğü bozulmuştur. Penetran (delici-kesici) yaralanmaların en sık nedeni ateşli silahlarla veya bıçaklı saldırılara bağlı delici kesici alet yaralanmalarıdır. Penetran yaralanmalar künt yaralanmalara göre daha ciddi seyreder. Kentsel bölgelerde penetran travma görülme yüzdesi artar (3) . Ateşli silah kullanımına bağlı oluşan yaralanmalarda organlarda büyük parankimal hasarlar gözlemlenir ve genellikle çoklu organ yaralanması eşlik etmektedir. Ateşli silah yaralanmasının ilk değerlendirilmesinde, neden olan silahın özellikleri ve mermi balistiği önemli faktör-lerdendir. Yumuşak doku hasarında en önemli faktör merminin hızı ve boyutudur (4,5) . BalistikMerminin doku ve organlar üzerindeki etkileri, diğer yaralanmalardan farklıdır. Önceleri kurşun yarasının şiddetinin silahla üretilen enerjiye bağlı olduğuna inanılıyordu (E=1/2 MV2). Bu teoriye göre, merminin büyüklüğü ve hızı enerji üretiminde önemlidir. Sonradan, bu teorinin doğru olmadığı belirlendi, çün-kü dokuya aktarılan enerji doku hasarında kritik bir

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Diagnosis and management of bladder injury by trauma surgeons

Cited by 80 publications

References 11 publications

Spontaneous Rupture of Urinary Bladder in a Young Alcoholic Male

Spontaneous Rupture of Urinary Bladder in a Young Alcoholic Male

Orthopedic Approach to the Early Management of Pelvic Injuries

Current Approachs to Urogenital System Injuries in High Energy Trauma Exposed

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