Intraperitoneal bladder injury

Intraperitoneal bladder injury

Intraperitoneal bladder injury refers to damage to the urinary bladder that results in the spillage of urine into the peritoneal cavity. The bladder is normally located in the pelvis and is considered extraperitoneal (outside the peritoneal cavity). However, certain traumatic events or injuries can lead to a rupture of the bladder wall, allowing urine to enter the peritoneal cavity.

Causes of Intraperitoneal Bladder Injury:

  1. Trauma: Blunt or penetrating trauma to the lower abdomen or pelvis, such as a motor vehicle accident, fall, or direct blow, can cause intraperitoneal bladder injury.
  2. Pelvic Fractures: Fractures of the pelvic bones may be associated with injuries to the bladder, potentially leading to intraperitoneal bladder rupture.
  3. Surgical Complications: In some cases, iatrogenic injuries during pelvic or abdominal surgeries may result in bladder perforation.

Clinical Presentation:

  1. Abdominal Pain: Patients may experience significant abdominal pain, especially in the lower abdomen.
  2. Signs of Peritonitis: The entry of urine into the peritoneal cavity can cause peritonitis, leading to symptoms such as abdominal tenderness, guarding, and rebound tenderness.
  3. Hematuria: Blood in the urine (hematuria) may be present.
  4. Lower Abdominal Distension: Accumulation of urine in the peritoneal cavity may lead to lower abdominal distension.

Diagnosis and Management:

  1. Imaging Studies: Imaging modalities such as computed tomography (CT) scans or cystography can help diagnose bladder injuries.
  2. Exploratory Surgery: In some cases, exploratory surgery may be necessary to assess and repair the bladder injury.
  3. Catheterization: A urinary catheter is often inserted to drain urine from the bladder and prevent further leakage into the peritoneal cavity.
  4. Surgical Repair: Severe cases of intraperitoneal bladder injury may require surgical repair to close the rupture and prevent complications.

Prompt diagnosis and appropriate management are crucial in cases of intraperitoneal bladder injury to prevent complications such as peritonitis and sepsis. Individuals suspected of having such injuries should seek immediate medical attention.