Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department
Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystog...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
CINQUILL Medical Publishers Inc.
2023-04-01
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| Series: | POCUS Journal |
| Subjects: | |
| Online Access: | https://ojs.library.queensu.ca/index.php/pocus/article/view/16239 |
| _version_ | 1797838004631371776 |
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| author | Helen J. Lu Edward H. Lee Stephen Alerhand |
| author_facet | Helen J. Lu Edward H. Lee Stephen Alerhand |
| author_sort | Helen J. Lu |
| collection | DOAJ |
| description |
Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystography is the standard imaging modality for diagnosis. However, this test is unlikely to be ordered in a patient with undifferentiated abdominal pain unless there is specific suspicion for this diagnosis. In our emergency department, a 48 year-old male with history of bladder cancer and TURBT two weeks prior to arrival presented with severe abdominal pain and difficulty urinating for 3 days. Point of care ultrasound (POCUS) revealed an irregularly shaped bladder, likely site of bladder rupture, and large amount of abdominal free fluid with sediment. These findings prompted an expedited diagnostic CT scan with cystography. Emergent exploratory laparotomy ultimately confirmed a small bladder defect with 2.5 L of urinary ascites. The diagnosis of non-traumatic bladder rupture can be overlooked in patients presenting with a peritonitic abdominen. The typically ordered test for such patients is standard CT, which carries a high false-negative rate for bladder rupture. This case highlights the utility of POCUS in facilitating a rapid diagnosis.
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| first_indexed | 2024-04-09T15:33:46Z |
| format | Article |
| id | doaj.art-d47897a9480d4515b412b113c24fa562 |
| institution | Directory Open Access Journal |
| issn | 2369-8543 |
| language | English |
| last_indexed | 2024-04-09T15:33:46Z |
| publishDate | 2023-04-01 |
| publisher | CINQUILL Medical Publishers Inc. |
| record_format | Article |
| series | POCUS Journal |
| spelling | doaj.art-d47897a9480d4515b412b113c24fa5622023-04-28T04:00:03ZengCINQUILL Medical Publishers Inc.POCUS Journal2369-85432023-04-018110.24908/pocus.v8i1.16239Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency DepartmentHelen J. Lu0Edward H. Lee1Stephen Alerhand2Rutgers New Jersey Medical SchoolHackensack University Medical CenterRutgers New Jersey Medical School Bladder rupture is an uncommon injury that leads to significant morbidity and mortality. Though occurring mostly due to trauma, this life-threatening pathology may also occur spontaneously or after a procedure such as transurethral resection of bladder tumor (TURBT). Computed tomography (CT) cystography is the standard imaging modality for diagnosis. However, this test is unlikely to be ordered in a patient with undifferentiated abdominal pain unless there is specific suspicion for this diagnosis. In our emergency department, a 48 year-old male with history of bladder cancer and TURBT two weeks prior to arrival presented with severe abdominal pain and difficulty urinating for 3 days. Point of care ultrasound (POCUS) revealed an irregularly shaped bladder, likely site of bladder rupture, and large amount of abdominal free fluid with sediment. These findings prompted an expedited diagnostic CT scan with cystography. Emergent exploratory laparotomy ultimately confirmed a small bladder defect with 2.5 L of urinary ascites. The diagnosis of non-traumatic bladder rupture can be overlooked in patients presenting with a peritonitic abdominen. The typically ordered test for such patients is standard CT, which carries a high false-negative rate for bladder rupture. This case highlights the utility of POCUS in facilitating a rapid diagnosis. https://ojs.library.queensu.ca/index.php/pocus/article/view/16239bladder rupturepoint-of-care ultrasoundPOCUS |
| spellingShingle | Helen J. Lu Edward H. Lee Stephen Alerhand Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department POCUS Journal bladder rupture point-of-care ultrasound POCUS |
| title | Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department |
| title_full | Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department |
| title_fullStr | Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department |
| title_full_unstemmed | Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department |
| title_short | Delayed Iatrogenic Bladder Rupture Diagnosed by POCUS in the Emergency Department |
| title_sort | delayed iatrogenic bladder rupture diagnosed by pocus in the emergency department |
| topic | bladder rupture point-of-care ultrasound POCUS |
| url | https://ojs.library.queensu.ca/index.php/pocus/article/view/16239 |
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