Combined intra- and extraperitoneal urinary bladder rupture – a rare seat-belt injury: A case report

Abstract

HighlightsCombined intra- and extraperitoneal traumatic urinary bladder ruptures without an underlying fracture are an absolute rarity.Timely diagnosis and appropriate therapy of urinary bladder ruptures are crucial in order to reduce postoperative morbidity.Physicians should maintain a high level of suspicion for urologic injuries following blunt abdominal trauma in the presence of nonspecific lower abdominal pain, gross haematuria and the inability to urinate.

Traumatic extraperitoneal bladder rupture in the absence of pelvic fracture in a patient with pelvic organ prolapse: A case report and review of the literature

“…He had no clinical signs of pelvic instability. A CT scan showed findings consistent with intra-and extraperitoneal bladder rupture without any evidence of pelvic fractures [20] . Similarly, in 2019, there was a case describing seat-belt induced intraperitoneal bladder rupture following a high-impact collision between a motor vehicle and tree [21] .…”

“…During our literature search, we were only able to find less than a handful of cases of blunt traumatic bladder rupture in the absence of a pelvic fracture. In 2017, a case of a 37-year-old patient who developed an intra- and extraperitoneal bladder injury as a result of blunt force during a high-velocity motor vehicle collision was published [20] . The patient presented with stable vital signs, abdominal tenderness and bruising of the lower abdomen on physical examination.…”

Extraordinarily Rare Isolated Intraperitoneal Urinary Bladder Rupture in Blunt Abdominal Injury Without Pelvic Fracture: An Aide-Mémoire

“…Up to 90% of bladder injuries in blunt abdominal trauma are often associated with concomitant pelvic fractures. Isolated traumatic BR is rare, but extraperitoneal rupture is frequent, accounting for 80% of the cases [3,6]. Of note, early recognition of bladder injury is crucial for proper intervention.…”

Delayed Presentation of Bladder Rupture Presenting as Ascites and Acute Kidney Injury

“…The urinary bladder is usually protected by pelvic structures owing to its deep location in the pelvis with a low injury rate of 0.87 to 1.6% among the blunt abdominal trauma cases [1,2]. Mechanisms of bladder injuries includes direct force towards a distended bladder, shearing force secondary to pelvic fracture, penetrating trauma and iatrogenic causes [2][3][4].…”

“…The urinary bladder is usually protected by pelvic structures owing to its deep location in the pelvis with a low injury rate of 0.87 to 1.6% among the blunt abdominal trauma cases [1,2]. Mechanisms of bladder injuries includes direct force towards a distended bladder, shearing force secondary to pelvic fracture, penetrating trauma and iatrogenic causes [2][3][4]. Traumatic urinary bladder injuries can be further classified into bladder contusion, extra peritoneal rupture (60%), intraperitoneal rupture (25%), and combined intraperitoneal and extra peritoneal ruptures (6%) [1,5,6].…”