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Nurul Shaliza Shamsudin

Abstract

Around 60% to 80% of all bladder injuries result from blunt abdominal trauma, however isolated intraperitoneal urinary bladder rupture is a rare entity (1, 2). The injury has an insidious presentation and often results in delayed diagnosis and management, hence may substantially increases mortality (3,4). We present a case of middle aged male with a delayed presentation of traumatic intraperitoneal bladder rupture that was discovered more than a week after the inciting event. He initially presented to emergency department with acute urinary retention and abdominal distention 5 days after an alleged assaulted. Contrasted CT abdomen demonstrated extravasation of contrast from the dome of the bladder indicating bladder perforation. Emergency laparotomy revealed a 10cm linear tear seen at the bladder dome. Although rare, delayed bladder injury presentation is possible and there should be a high clinical suspicion of bladder injury in trauma patient with unexplained abdominal findings. This case should serve as a cautionary tale for the assessment of the pseudo-renal failure patient. In most patient with urinary ascites, there may be great disturbances in serum biochemistry mimicking renal failure such as elevated urea, creatinine as well as hyperkalaemia.

 

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Keywords

Traumatic bladder rupture, pseudo-renal failure, ascites

References
1. Mokoena T, Naidu AG. Diagnostic difficulties in patients with a ruptured bladder. British Journal of Surgery. 1995; 82 (1):67-70.
2. Gomez RG, Ceballos L et al. Concensus statement on bladder injuries. BJU International. 2004; 94 (1):27-32.
3. Tezval H, Tezval M et al. Urinary tract injuries in patients with multiple trauma. World Journal of Urology. 2007; 25 (2):177-184.
4. Hsieh CH, Chen RJ, Fang FJ et al. Diagnosis and management of bladder injury of trauma surgeons. American Journal of Surgery. 2002; 184 (2); 143-147.
Section
EMAS Meeting 2018 Abtracts