Urinary Ascites from Spontaneous Rupture of the Bladder: Report of a Case

自發性膀胱破裂引發尿性腹水：一病例報告

吳淑明(Lydia-S. Go) ； 唐鴻舜(Hung-Shang Tang) ； 葉錦龍(Chin-Long Yeh) ； 楊東和(Ton-Ho Young)

《臺灣消化醫學雜誌》 25卷1期 (2008/03) Pp. 18-21

https://doi.org/10.6557/GJT.200803_25(1).0004

摘要

由尿液造成的腹水非常少見，它幾乎只發生在因爲膀胱破裂導致尿液漏到腹膜腔的結果。膀胱破裂常見的原因爲外傷性的傷害，但也可以是自發性的，特別是酗酒者。診斷因膀胱破裂導致尿性腹水在開始的時候常常會被誤判，且造成適當處置的延遲。在此，我們報導一例成年男性，因爲腹部脹痛及解尿困難而被照會，他的腹水一開始被誤以爲是肝臟疾病引起的，後來經腹腔鏡檢查，發現在膀胱穹頂有一撕裂處。回溯分析原來的腹水發現，有高濃度的肌酸酐，證實這腹水就是尿夜。

關鍵字

尿性腹水 ； 膀胱破裂 ； 逆行性膀胱造影 ； 剖腹手術

並列摘要

Urine as a cause of ascites is relatively unusual. This occurs when urine leaks into the peritoneal cavity as a result of bladder rupture. Bladder ruptures are commonly due to traumatic injuries but may also occur spontaneously, specially among alcoholics. The diagnosis of urinary ascites secondary to bladder rupture is usually missed at first and proper management is delayed. Here we describe a young male patient who consulted our hospital because of abdominal distension and difficult micturation. His ascites was mistakenly assumed to be of hepatic origin. Laparotomy demonstrated a tear at the bladder dome. Retrospective analysis of the previous ascitic fluid showed high creatinine levels, confirming the ascitic fluid to be urine.

並列關鍵字

urinary ascites ； bladder rupture ； retrograde cystogram ； laparotomy