Blunt Traumatic Intraperitoneal Bladder Rupture After Alcohol Intake That Responds to Non-Operative Conservative Management

Abstract

Blunt traumatic intraperitoneal bladder rupture is usually treated by surgical repair. We report a patient with intraperitoneal bladder rupture secondary to blunt abdominal trauma that responded to nonoperative conservative management using a transurethral catheter. A 58-year-old woman was admitted to our Department of Internal Medicine complaining of lower abdominal pain and urinary retention after drinking alcohol. Computed tomography (CT) scan revealed collection of fluid in the abdominal cavity and fresh blood clots in the bladder. At 2 days after admission, she was moved from the Department of Internal Medicine to Urology. Cystoscopy revealed an old hematoma in the bladder. She complained of abdominal pain when the Foley catheter was removed. At 3 days after admission, cystoscopy revealed a small tear at the bladder dome, which led to a definitive diagnosis of intraperitoneal bladder rupture. At 4 days after admission, a CT scan detected only a small amount of fluid in the abdominal cavity. Conservative therapy was continued because urine could be constantly drained. At 2 weeks after admission, the bladder rupture had healed.

An uncommon and easily overlooked case: Delayed intraperitoneal bladder rupture following blunt trauma: A case report and review of the literature

“…Clinical signs of traumatic bladder injuries are nonspecific and mainly involve gross hematuria, suprapubic pain/tenderness, and urinary difficulties. [ 2 , 3 ] Clinicians can easily diagnose and treat bladder injuries when typical clinical signs are present, but patients with atypical symptoms, especially delayed bladder rupture, may be overlooked or misdiagnosed, potentially impacting treatment efficacy. In this study, we present a rare and easily overlooked case of delayed intraperitoneal bladder rupture resulting from blunt trauma.…”

A Complex Case of Emphysematous Cystitis in a Peritoneal Dialysis Patient

“…Rupture of the bladder is an uncommon complication of EC that may have grave consequences if not diagnosed and treated early [4]. For smaller intraperitoneal bladder ruptures, recent reports have shown that a conservative approach may be sufficient if urinary antibiotic prophylaxis is continued after initial antibiotic therapy, and continued urinary drainage through an indwelling catheter is provided for a minimum of two weeks, until closure of the perforation is evident on the CT cystogram [5][6][7][8]. Similarly, certain international guidelines have recently adopted a conservative approach in the management of small, uncomplicated intraperitoneal bladder perforations [9].…”

Alcohol Intoxication Is Associated With Bladder Injury and Bladder Surgical Repair in Patients Sustaining Motor Vehicle Collisions

“…4,9 Despite the biological plausibility, the relationship between alcohol intoxication and bladder injury following MVCs is only explored by a few case reports and small series. [10][11][12] Given the World Society of Emergency Surgery and American Association for the Surgery of Trauma and AUA (American Urological Association) guidelines recommend intraperitoneal bladder ruptures be managed with surgical repair, bladder injuries may dramatically change a patient's clinical course. 13,14 Bladder injuries are rarely isolated, with 94%-97% of cases associated with other injuries including pelvic long bone fracture, head/spinal, or visceral injuries.…”