Delayed diagnosis of atraumatic urinary bladder rupture.
Tamir Sholklapper1, Sherif Elmahdy2
1Georgetown University School of Medicine, Georgetown University, Washington, DC, USA.
Urology Case Reports
|June 7, 2021
Summary
Spontaneous rupture of the urinary bladder (SRUB) is a rare condition often missed. This case highlights multiple causes and a link to phosphate enemas, emphasizing swift diagnosis for better outcomes.
Area of Science:
- Urology
- Gastroenterology
Background:
- Spontaneous rupture of the urinary bladder (SRUB) is a rare and potentially fatal condition.
- Diagnosis is often delayed due to non-specific clinical presentations.
Observation:
- A case of SRUB is presented with multiple contributing etiological factors.
- The rupture occurred in temporal association with the administration of a phosphate enema.
Findings:
- The case underscores the importance of considering SRUB in patients with abdominal pain, even with atypical symptoms.
- Phosphate enemas may be an iatrogenic factor contributing to bladder rupture in susceptible individuals.
Implications:
- Early recognition and diagnosis of SRUB are critical for timely management and improved patient survival.
- This case highlights the need for careful patient selection and monitoring when administering phosphate enemas.
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
90
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
90
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
332
Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
332
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
181
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
181
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
97
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
97
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
399
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
399
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
108
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
108