Urological injuries associated with pelvic fractures: A case report of a detached bone segment inside the bladder

Alfayez, Saud M.; Allimmia, Khalid; Alshammri, Ahmad; Serro, Firas; Almogbel, Rakan A.; Dous, Abdullah Bin; Almannie, Raed; Palencia, J

doi:10.1016/j.ijscr.2016.09.054

Cited by 6 publications

(11 citation statements)

References 14 publications

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“…There is also a possibility of urinary bladder injury in patients with sacral injury. Gross hematuria is a hallmark sign of bladder injury in the presence of pelvic fracture in 16-27% of patients (Alfayez et al 2016). However, microscopic hematuria in the absence of overt signs of lower urinary tract injury is probably not indicative of bladder rupture (Figler et al 2012), just as in this case, where there was no gross hematuria but microscopic examination of the urine did detect the presence of red blood cells.…”

Section: Discussionmentioning

confidence: 65%

“…A systematic method of approaching a trauma patient in Advanced Trauma Life Support (ATLS) protocol was taught to emergency doctors so that any lifethreatening injury is not missed out and may be promptly attended if any such was found. Sacral fracture, although not life-threatening, could have serious complications which are neurological injury (Beckmann & Chinapuvvula 2017) and urological injury with concurrent pelvic fracture (Alfayez et al 2016). However, due to its rarity, it is frequently overlooked and hence, not properly treated (Rodrigues-Pinto et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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Pain in the Genital: A Clue to a Rare Injury

Ze¹

2019

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Dalam trauma, satu pendekatan yang sistematik telah dibentuk untuk membantu pegawai perubatan dan pakar bedah mengenalpasti kecederaan yang akan meragut nyawa supaya rawatan boleh diberi dengan serta-merta untuk menyelamatkan nyawa dan mengurangkan kadar kematian. Pendekatan ini juga melibatkan pemeriksaan dari kepala ke kaki supaya semua kecederaan dapat dikenal pasti dan dirawat. Kepatahan tulang sakrum sungguhpun jarang dijumpai, boleh membawa komplikasi yang serius. Kes ini akan membincangkan seorang pesakit trauma yang datang dengan simptom sakit di alat kelamin di mana pemeriksaan adalah normal. Kepatahan tulang sakrum hanya dijumpai apabila x-ray bahagian pinggul dibuat, dan tidak disyaki pada mulanya. Mujur pesakit ini tidak mengalami sebarang komplikasi yang serius. Tujuan kes ini dilaporkan adalah untuk membincangkan tentang kepentingan untuk menyiasat dengan lebih lanjut mengenai aduan pesakit, seperti dalam kes ini di mana pesakit mengadu mengenai kesakitan di alat kelamin yang seterusnya berakhir dengan kepatahan sakrum.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Pain in the Genital: A Clue to a Rare Injury

Ze¹

2019

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“…14,20 Pelvic fracture is a significant risk factor for bladder injury with 90% of bladder injuries associated with pelvic fracture. 21 Given the high risk of concomitant injury, first responders, trauma providers, and physicians are taught to have a high index of suspicion for bladder injury in patients with a pelvic fracture. 14,21 Interestingly, we found that a BAC above the legal limit of 0.08 g/dL was more predictive of bladder injury requiring surgical repair than occurrence of pelvic fracture.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Purpose:Alcohol intoxication is a known risk factor for motor vehicle collisions. We hypothesize ethanol intoxication increases the risk of bladder injury and surgical repair, especially at higher blood alcohol content levels.Materials and Methods:We identified all patients involved in motor vehicle collisions from the National Trauma Data Bank from 2017-2019. Patients were categorized into an intoxication and intoxication negative group. Variables collected included age, sex, blood alcohol content level, driver status, seat belt restraint use, nonalcoholic intoxication, pelvic fracture, and Injury Severity Scale. Primary outcome measures of bladder injury and bladder surgical repair were assessed and interaction with pelvic fracture and restraint use were measured.Results:We identified 594,484 patients and 97,831 (16.5%) had a positive alcohol screen. Patients in the intoxication group were more likely to be intoxicated with other substances (32.8% vs 14.6%, P < .001), have a bladder injury (1% vs 0.4%, P < .001) and receive bladder surgical repair (0.7% vs 0.15%, P < .001). Injury Severity Scale and pelvic fracture were statistically significant predictors of bladder injury. In adjusted analysis, higher blood alcohol content was associated with both outcomes. Above the legal limit, alcohol intoxication was more predictive of bladder surgical repair than pelvic fracture. The association of alcohol intoxication with both outcomes did not differ by pelvic fracture, but strengthened with seat belt use at higher intoxication levels.Conclusions:Alcohol intoxication is independently associated with increased risk of bladder injury and subsequent bladder surgical repair following motor vehicle collisions. Trauma providers should have a high index of suspicion for bladder injuries in alcohol intoxicated patients, particularly those using seat belt restraints.

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“…Associated concurrent GU injuries range between 6 and 15% of the cases [ 9 , 11 – 13 ]. Although the bladder and urethra are internalized, sterile structures susceptible to injury from pelvic fractures.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Vaginal Laceration in an Open Pelvic Fracture Case Report: A Novel, Prophylactic Antibiotic Delivery Mechanism

Suneja

Tischler

Lockwood

et al. 2021

Case Reports in Orthopedics

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Introduction. Rotational displaced pelvic ring injuries are associated with internal injuries to both the gastrointestinal and genitourinary viscera and anatomic structures. Vaginal lacerations and open genitourinary-associated injuries are at increased risk of mortality due to sepsis. Case Presentation. This case presents a 65-year-old female status post-pedestrian-vehicle struck diagnosed with an open pelvic fracture with extension into the outer one-third of the vaginal wall. The patient was successfully treated with emergent surgical debridement, pelvic stabilization, and internal placement of a novel combination of metronidazole antibiotic gel and vancomycin/tobramycin Polymethyl methacrylate beads. Conclusion. No evidence of infection was observed with the use of topical metronidazole-coated vancomycin/tobramycin Polymethyl methacrylate beads for contaminated open pelvic fracture injury involving the vaginal wall. Further research on antibiotic gels for use in high-risk open fractures is required.

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Urological injuries associated with pelvic fractures: A case report of a detached bone segment inside the bladder

Cited by 6 publications

References 14 publications

Pain in the Genital: A Clue to a Rare Injury

Pain in the Genital: A Clue to a Rare Injury

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

Vaginal Laceration in an Open Pelvic Fracture Case Report: A Novel, Prophylactic Antibiotic Delivery Mechanism

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