Peritonitis due to spontaneous rupture of the urinary bladder in an end stage renal disease patient with anuria.
- Author:
Won Kyu LEE
1
;
Young Sam KIM
;
Bong Hwan KIM
;
Yoon Hyeong KIM
;
Yoo Soon KO
;
Hyung Ki KIM
;
Byeong Kwon LEE
Author Information
1. Department of Internal Medicine, Incheon Christian Hospital, Incheon, Korea. hyungmed@hanmail.net
- Publication Type:Case Report
- Keywords:
Spontaneous rupture;
Bladder;
End stage renal disease;
Peritonitis
- MeSH:
Alcoholism;
Anuria*;
Ascites;
Fever;
Humans;
Kidney Failure, Chronic*;
Laparotomy;
Peritonitis*;
Renal Insufficiency;
Rupture;
Rupture, Spontaneous*;
Sepsis;
Suppuration;
Tomography, X-Ray Computed;
Urinary Bladder*;
Urinary Tract;
Urinary Tract Infections;
Vomiting
- From:Korean Journal of Medicine
2007;72(6):679-683
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Patients with nonfunctioning bladders, such as found in anuric renal failure, are prone to a severe form of urinary tract infection called pyocystis. Pyocystis is the accumulation of pus in the bladder. Anuric patients are often believed to be incapable of acquiring a urinary pathogen; thus, the urinary tract may be mistakenly discounted as a possible source of sepsis and bladder rupture. Although bladder rupture is normally associated with trauma, spontaneous bladder rupture may occur, especially in patients with mental disabilities, alcohol abuse and urinary tract infection. We report a rare case of a spontaneous intraperitoneal bladder rupture, probably precipitated by pyocystis. Symptoms and signs were atypical and included pain and vomiting with fever, abdominal distension and ascites. An abdominal CT and retrograde cystography showed a large quantity of intraperitoneal fluid and tearing in the dome of the bladder. Repair of the rupture site of the bladder after laparotomy was performed. However,, the patient expired due to peritonitis and pulmonary infection.
