[Extraperitoneal bladder rupture coinciding with bone fragments: the case for surgical treatment].
BACKGROUND
In closed traumatic bladder ruptures, a surgical treatment of the intraperitoneal rupture, and a conservative approach to the extraperitoneal one, with bladder catheter, antibiotics and confirmation of bladder wound closure after two to three weeks-, was recommended. Only recently, attention was paid to the importance of the presence of bone fragments of the pelvic fractures, that in the vecinity of a bladder catheter or urinary infection may give raise to either severe pelvic infection or permanent urinary fistula.


METHODS
The two cases of extraperitoneal bladder rupture here presented, demonstrate the difficulties of a secure diagnosis by CT, and the potential severity of the existence of bone fragments impronting the bladder disruption.


CONCLUSIONS
Recent consensus on genitourinary trauma emphasizes the need to pay attention to the presence of bone fragments of the pelvic ring fractures in cases of closed bladder rupture. In cases of extraperitoneal bladder rupture with bone fragments in the vecinity, bladder endoscopic examination and surgical treatment may be needed.
Fariña Pérez
Luis A
LA
Servicio de Urología, Hospital POVISA, Vigo, Pontevedra, España. luisfarina@yahoo.com
Pesqueira Santiago
Daniel
D
Posadilla Casquete
Pedro
P
Trinidad López
Carmen
C
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D010384:Pelvic Bones / Q000293:injuries*; D012421:Rupture; D001743:Urinary Bladder / Q000293:injuries* / Q000601:surgery*