Extraperitoneal bladder rupture with severe lacerations of the urogenital diaphragm: a case reportReport as inadecuate




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Cases Journal

, 2:56

First Online: 15 January 2009Received: 27 October 2008Accepted: 15 January 2009DOI: 10.1186-1757-1626-2-56

Cite this article as: Hagiwara, A., Nishi, K., Ito, K. et al. Cases Journal 2009 2: 56. doi:10.1186-1757-1626-2-56

Abstract

BackgroundA 65-year woman injured by automobile had an open-book type pelvic fracture and extraperitoneal bladder rupture.

Case presentationNon-surgical management was selected because of suspected minor leakage. A follow-up CT cystography on day 21 showed a large urinoma. In the sagittal reconstruction CT images, the bladder was displaced downwards. Surgery was performed. Surgical findings showed that the bladder neck and the urethra were not anchored because of a laceration in the urogenital diaphragm. The bladder base had descended to the inferior margin of the pubic bone and a laceration of about 3 cm was found in the anterior surface of the bladder neck. The laceration was sutured, and the wall of the urinoma was extensively resected. The postoperative course was uneventful.

ConclusionAn extraperitoneal bladder rupture associated with a severe laceration in the urogenital diaphragm will be indicated for surgery when the bladder is not anchored and healing is prevented. Sagittal reconstruction CT cystography was effective for this diagnosis.

Electronic supplementary materialThe online version of this article doi:10.1186-1757-1626-2-56 contains supplementary material, which is available to authorized users.

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Author: Akiyoshi Hagiwara - Koichiro Nishi - Keiichi Ito - Musasi Tobe - Tomohiko Asano - Masamichi Hayakawa

Source: https://link.springer.com/







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