Clinical Observation on Bladder Rupture

Park, Tae Woong; Kim, Se Kyong

Abstract

For 10 years and 10 months duration from January 1966 to October 1976. 28 patients with bladder rupture (19 patients had intraperitoneal bladder rupture and 9 patients had extraperitoneal rupture) were observed, among 131 patients hospitalized with urogenital injuries. 1) In this series, the bladder rupture (28 patients) formed 21.4 per cent of the total number of urogenital injuries (131 patients). 2) The 28 patients comprised 22 male and 6 female cases. Three patients were belonged to the age group of 0 to 19 years old, 16 cases were 20 to 39 years old, 4 were 40 to 49 years old, 4 were 50 to 59 years old, and one was 62 years old. 3) Traffic accidents were responsible for the injury in 13 patients, direct blow in 4 patients, industrial accidents in 3 patients, iatrogenic injury in 2 patients, fall down in one patient and in one patient the bladder rupture developed during delivery. Spontaneous bladder ruptures were seen in 4 patients. 4) Of the 28 patients, 15 bad an associated fractured pelvis. Fractured of the both pubic rami were most frequent: 7 cases, unilateral pubic ramus fractures were the next, and acetabular fractures: 2 cases, separation of the symphysis pubis: 2 cases, fracture of wing of the ilium. one case and communized pelvic ring fracture : one case were also noted. 5) Diagnosis was made by retrograde cystography, cystoscopy and laparotomy. Ninety three per cent of the diagnosis was made by retrograde cystography. 6) Ten patients with intraperitoneal rupture and 8 patients with extraperitoneal rupture were treated by operative repair of the defect with suprapubic cystostomy and drainage of the perivesical space. Six patients with intraperitoneal rupture and one patient with extraperitoneal rupture were treated by operative repair of the defect with indwelling urethral catheter and drainage of the perivesical space. The remaining 3 patients died soon after arrival to hospital with heavy injury of several visceral organs and one died of preexisting bladder tumor. 7) There was a 14. 3 per cent mortality rate. Early diagnosis and adequate treatment of bladder rupture is essential to reduce mortality.