Urosepsis complicated by a spontaneous bladder perforation

Lutwak, Nancy; Dill, Curt

doi:10.1136/bcr.08.2011.4609

Cited by 4 publications

(6 citation statements)

References 7 publications

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“…Even with proper diagnosis, surgical intervention is mandatory if the patient is unstable, deteriorating or clearly in peritonitis [ 2 , 5 ]. As in our case, if there is bladder necrosis [ 5 , 7 , 10 , 13 ], it necessitates the removal of the necrotic part of the bladder, in addition to just closing the perforation and washing the peritoneal cavity.…”

Section: Discussionmentioning

confidence: 93%

“…Spontaneous bladder rupture represents only 3.4% of these cases [ 2 ]. It results mostly from an underlying pathology [ 1 , 2 , 10 , 13 ], and is a rare complication of urosepsis [ 1 , 2 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although differential diagnosis must certainly include spontaneous bladder rupture in patients with cystitis with or without indwelling catheter [ 4 , 8 ], investigation should not cause further delays and preclude prompt surgical intervention in case of presumed digestive tract perforation or peritonitis [ 2 , 5 , 6 , 10 , 13 , 16 ]. Except for occasional cases of intraperitoneal bladder perforation that are stable and manageable without surgery [ 4 , 7 ], peritonitis from other causes than bladder perforation has to be ruled out [ [1] , [2] , [3] , 6 , 10 , 13 , 16 ]. Additionally, surgical intervention remains the mainstay of treatment for bladder perforation in the majority of cases [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

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Pneumoperitoneum and peritonitis secondary to perforation of an infected bladder

Bergeron

Lewinshtein

Bure

et al. 2021

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pneumoperitoneum and peritonitis secondary to perforation of an infected bladder

Bergeron

Lewinshtein

Bure

et al. 2021

International Journal of Surgery Case Reports

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“…In people, urosepsis has been reported as the underlying cause of spontaneous urinary bladder rupture. 22,23 Based on these facts, the spontaneous rupture of the urinary bladder in this cat could be secondary to infection and it should be part of the differentials when evaluating cases of spontaneous uroabdomen in small animals.…”

Section: Discussionmentioning

confidence: 98%

Successful resolution of urothorax secondary to non-traumatic uroabdomen in a cat managed with peritoneal dialysis as a bridge to surgery

Donati¹,

Londoño

Fravega³

et al. 2021

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 9-year-old neutered male domestic shorthair cat was presented for evaluation of severe hemodynamic collapse and suspected lower urinary tract disease. On admission, severe metabolic acidosis, hyperkalemia and azotemia, and electrocardiographic findings consistent with cardiotoxicity were identified. The diagnosis of uroabdomen was made based on abdominal fluid to plasma concentration ratios of creatinine and potassium. A central line catheter was placed percutaneously into the abdomen for peritoneal drainage and used for peritoneal dialysis as a bridge to surgery. Retrograde contrast cystography confirmed rupture of the urinary bladder. Point-of-care ultrasound of the chest postoperatively revealed the presence of mild pleural effusion. Echocardiography was then performed showing no evidence of cardiac disease. Pleural fluid analysis revealed a transudate with a creatinine ratio of 2.38 ([Creatinine]pleural fluid/[Creatinine]plasma), consistent with the diagnosis of urothorax. The cat recovered uneventfully from surgery and was monitored for signs of respiratory distress during the rest of its stay in hospital. The cat was discharged 4 days later and the pleural effusion resolved without further medical intervention. Relevance and novel information There is limited information on the causes of urothorax and uroabdomen management of feline patients. Pleural effusion is a complication observed in critically ill cats secondary to fluid overload, underlying cardiomyopathy, primary thoracic pathology or a combination of these. To our knowledge, this is the first report of urothorax in a cat secondary to non-traumatic uroabdomen. Careful monitoring of respiratory signs consistent with pleural space disease is recommended in cases of uroabdomen.

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“…Lutwak reported a rare presentation of a 32 year old diabetic male who presented with bladder rupture and urosepsis following TURBT [9]. Various others have reinforced this particular etiology of diabetes causing decreased bladder sensitivity due to autonomic neuropathy leading to chronic urinary retention and recurrent infection which might predispose to spontaneous bladder rupture.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of Urinary Bladder (SRUB) in a Young Male, Presenting as Anuria – A Case Report and Review of Literature

Sekar¹,

Krishnamoorthy²,

Shroff³

2014

TOUNJ

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Spontaneous rupture of urinary bladder is a rare condition. Most of the bladder ruptures occur in association with blunt or penetrating injuries to the lower abdomen. Most often, a vague lower abdominal pain is the mode of presentation. Rarely patients present with oliguria, anuria, uremia or urosepsis. A forty year old male, under the influence of alcohol, presented with lower abdominal pain and anuria for two days with abnormal renal function. He denied history of blunt trauma. He was diagnosed to have an intra-peritoneal rupture of urinary bladder. He underwent emergency laparotomy with repair of bladder rupture. This case report illustrates the need for a high index of clinical suspicion. Prompt diagnosis and appropriate management will help in preventing a poor clinical outcome in patients with spontaneous bladder perforation. If left untreated or if there is a considerable delay in diagnosis and intervention, it usually is associated with a high morbidity.

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Urosepsis complicated by a spontaneous bladder perforation

Cited by 4 publications

References 7 publications

Pneumoperitoneum and peritonitis secondary to perforation of an infected bladder

Pneumoperitoneum and peritonitis secondary to perforation of an infected bladder

Successful resolution of urothorax secondary to non-traumatic uroabdomen in a cat managed with peritoneal dialysis as a bridge to surgery

Spontaneous Rupture of Urinary Bladder (SRUB) in a Young Male, Presenting as Anuria – A Case Report and Review of Literature

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