MORBIDITY ASSOCIATED WITH NONOPERATIVE MANAGEMENT OF EXTRAPERITONEAL BLADDER INJURIES

被引:59
作者
KOTKIN, L [1 ]
KOCH, MO [1 ]
机构
[1] VANDERBILT UNIV,MED CTR,DEPT UROL,NASHVILLE,TN 37232
关键词
D O I
10.1097/00005373-199506000-00012
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Foley catheter drainage alone has become routine management for extraperitoneal bladder ruptures In many medical centers, and few reports address treatment failures with this approach. Over the last 10 years, 70 patients with bladder ruptures were managed at our institution, Thirty-six of these had extraperitoneal injuries caused by blunt trauma, and 29 of these were treated by catheter drainage alone. Of those patients managed nonoperatively, 74% had spontaneous healing within 10 to 14 days; however, 26% had significant complications, including delayed healing, vesicocutaneous fistula, septic events, bladder calculi, or death, Although our results confirm previous reports in the literature that most patients with extraperitoneal bladder ruptures do well with nonoperative management, they also point out that a significant subset of patients do not. We were unable to identify presenting features that would predict an unfavorable outcome, although patients with multiple pelvic fractures seem to be at high risk. The maintenance of adequate catheter drainage and use of antibiotic prophylaxis seems to have a significant impact on outcome.
引用
收藏
页码:895 / 898
页数:4
相关论文
共 11 条
[1]  
BROSMAN SA, 1976, SURG GYNECOL OBSTET, V143, P605
[2]   MAJOR BLADDER TRAUMA - MECHANISMS OF INJURY AND A UNIFIED METHOD OF DIAGNOSIS AND REPAIR [J].
CARROLL, PR ;
MCANINCH, JW .
JOURNAL OF UROLOGY, 1984, 132 (02) :254-257
[3]   BLADDER TRAUMA IN MULTIPLE INJURED PATIENT [J].
CASS, AS .
JOURNAL OF UROLOGY, 1976, 115 (06) :667-669
[4]   MANAGEMENT OF EXTRAPERITONEAL RUPTURES OF BLADDER CAUSED BY EXTERNAL TRAUMA [J].
CASS, AS ;
LUXENBERG, M .
UROLOGY, 1989, 33 (03) :179-183
[5]   NONOPERATIVE MANAGEMENT OF BLADDER RUPTURE FROM EXTERNAL TRAUMA [J].
CASS, AS ;
JOHNSON, CF ;
KHAN, AU ;
MATSUURA, JK ;
GODEC, CJ .
UROLOGY, 1983, 22 (01) :27-29
[6]   A REVISION OF THE TRAUMA SCORE [J].
CHAMPION, HR ;
SACCO, WJ ;
COPES, WS ;
GANN, DS ;
GENNARELLI, TA ;
FLANAGAN, ME .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1989, 29 (05) :623-629
[7]   MANAGEMENT OF THE RUPTURED BLADDER - 7 YEARS OF EXPERIENCE WITH 111 CASES [J].
CORRIERE, JN ;
SANDLER, CM .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1986, 26 (09) :830-833
[8]  
MCCONNELL JD, 1982, UROL CLIN N AM, V9, P293
[9]   NON-OPERATIVE TREATMENT OF RUPTURED BLADDER [J].
RICHARDSON, JR ;
LEADBETTER, GW .
JOURNAL OF UROLOGY, 1975, 114 (02) :213-216
[10]   RUPTURE OF BLADDER - UNUSUAL FEATURES [J].
RIESER, C ;
NICHOLAS, E .
JOURNAL OF UROLOGY, 1963, 90 (01) :53-&