Authors: M. Frank; T. Dědek; M. Broďák * Authors‘ workplace: Chirurgická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Hradec Králové, přednosta: prof. MUDr. Alexander Ferko, CSc. ; Urologická klinika Lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Hradec Králové, přednosta: MUDr. Miloš Broďák, Ph. D. * Published in: Rozhl. Chir., 2011, roč. 90, č. 4, s. 226-228. Category: Monothematic special - Original
The authors are presenting a case of 42-year-old polytraumatized man with pelvic fracture associated with extraperitoneal urinary bladder rupture. This was verified by intraoperative retrograde cystography and treated with suture without making suprapubic tube drainage. Urinary draining was assured with a transurethral permanent urinary catheter. Conversion from external fixation to internal osteosynthesis of pelvic fracture was performed as far as 26 days after admission for significantly poor overall condition of the patient. Injury of the bladder and pelvic fracture healed without any complications. This case review points to the possibility of surgical repair of bladder rupture without epicystostomy, which is an obstacle or an increased risk of infection for internal fixation of anterior part of the pelvic ring. Suprapubic tube is not beneficial in surgical repair of urinary bladder rupture. However, it is normal practice that the suprapubic tube associated with bladder suture is indicated according to urology department tradition or by an individual physician – urologist himself. In the choice of surgical treatment tactics in these types of injuries proper communication between the urologist and the surgeon dealing with complex pelvic trauma is important.
Key words: pelvic fracture – rupture – bladder – suprapubic tube
1. Corriere, J. N., Sandler, C. M. Bladder rupture from external trauma: diagnosis and management. World J. Urol., 1999; 17 : 84–89.
2. Parry, N. G., Rozycki, G. S., Feliciano, D. V., et al. Traumatic Rupture of the Urinary Bladder: Is the Suprapubic Tube Necessary? J. Trauma, 2003; 54 : 431–436.
3. Džupa, V., Chmelová, J., Pavelka, T., et al. Multicentrická studie pacientů s poraněním pánve: základní analýza souboru. Acta Chir. Orthop. Traumatol. Cech., 2009; 76 : 404–409.
4. Pavelka, T., Houček, P., Hora, M., et al. Urologické poranění při zlomeninách pánevního kruhu. Acta Chir. Orthop. Traumatol. Cech., 2010; 77 : 18–23.
5. Tile, M., Helfet, D. L., Kellam, J. F. Fractures of the Pelvis and Acetabulum. Third edition. Philadelphia, Lippincott Williams and Wilkins, 2003.
6. Hsieh, C. H., Chen, R. J., Fang, J. F., et al. Diagnosis and management of bladder injury by trauma surgeons. Am. J. Surg., 2002; 184 : 143–147.
7. Pao, D. M., Ellis, J. H., Cohan, R. H., et al. Utility of Routine Trauma CT in the Detection of Bladder Rupture. Acad. Radiol., 2000; 7 : 317–324.
8. Chmelová, J., Džupa, V., Pleva, L. Role zobrazovacích metod v diagnostice poranění pánve. Acta Chir. Orthop. Traumatol. Cech., 2008; 75 : 93–98.
9. Routt, M. L., Simonianin, P. T., Defalco, A. J., et al. Internal Fixation in Pelvic Fracture and Primary Repairs of Associated Genitourinary Disruptions: a Team Approach. J. Trauma, 1996; 40 : 784–790.
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