[Two cases of traumatic bladder rupture with multiple organ failure]

Area of Science:

• Urology
• Trauma Surgery
• Critical Care Medicine

Background:

• Traumatic bladder rupture is a severe injury that can lead to significant morbidity and mortality.
• Multiple organ failure (MOF) is a known complication of severe trauma and sepsis.

Observation:

• Two cases of traumatic bladder rupture complicated by MOF are presented.
• Case 1: Extraperitoneal rupture with femoral fracture, treated conservatively, led to MOF secondary to intrapelvic abscess and ARDS from fat embolism.
• Case 2: Intraperitoneal rupture with associated splenic, intestinal, and diaphragmatic injuries in a lymphoma patient, complicated by MOF postoperatively.

Findings:

• Conservative management in Case 1 did not prevent MOF.
• Surgical repair and supportive care in Case 2 were insufficient to prevent MOF, leading to death.
• Both cases highlight the critical role of managing associated injuries and preventing/treating infections.

Implications:

• Aggressive management of infection and intensive chemotherapy are essential when treating bladder rupture with other visceral injuries.
• Early recognition and management of complications like abscesses and organ dysfunction are vital for improving outcomes.
• This case series underscores the complexity of managing severe bladder trauma and its systemic consequences.