PDF(Pubmed)
Abstract：
Bladder rupture related to Foley catheter insertion is a rare condition mainly reported in patients with chronic bladder disease. In the present case, this rare condition was associated with massive hematoma due to active arterial bleeding, which was treated by embolization. We present the case of a 38-year-old woman admitted to the gastroenterology department with decompensated alcoholic liver cirrhosis, anemia, malnutrition, and diabetes. Six days after admission, she presented with hypotension and tachycardia associated with gross hematuria. An abdominal computed tomography scan revealed a Foley catheterization-related bladder perforation and a massive extra-peritoneal hematoma caused by active arterial bleeding from a distal branch of the right vesical artery. A successful embolization was performed with microparticles and coiled with complete hemorrhage control on post-procedure imaging. The bladder perforation was treated conservatively with a urinary drainage catheter, irrigation, and antibiotics. Despite these measures, the patient died 15 days later due to liver failure and sepsis. Our case highlights that commonly performed simple procedures can lead to severe complications, especially in frail patients.
摘要：
与Foley导管插入相关的膀胱破裂是一种罕见的疾病，主要在患有慢性膀胱疾病的患者中报道。在目前的情况下,这种罕见的情况与由于活动性动脉出血引起的大量血肿有关，通过栓塞治疗。我们介绍了一名38岁的女性，因胃肠病科住院，患有失代偿性酒精性肝硬化，贫血,营养不良,和糖尿病。入院六天后,她出现低血压和心动过速并伴有肉眼血尿。腹部计算机断层扫描扫描显示Foley导管插入相关的膀胱穿孔和由右膀胱动脉远端分支的活动性动脉出血引起的大量腹膜外血肿。成功的栓塞是用微粒进行的，并在术后成像中完全控制出血。膀胱穿孔采用尿引流导管保守治疗，灌溉,和抗生素。尽管采取了这些措施,患者15天后因肝功能衰竭和脓毒症死亡.我们的案例突出表明，通常进行简单的手术会导致严重的并发症，尤其是体弱者。
