Acute Care Surgery Handbook by Salomone Di Saverio Fausto Catena Luca Ansaloni Federico Coccolini & George Velmahos

Author:Salomone Di Saverio, Fausto Catena, Luca Ansaloni, Federico Coccolini & George Velmahos
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Fig. 14.2Extraperitoneal bladder rupture

Cystoscopy is a minimally invasive procedure that can help identify the location and size of the bladder rupture as well as provide additional information regarding the lesion and the position of the ureters and bladder neck. Also, cystoscopy can be used to diagnose foreign bodies inside the bladder [11].

14.1.3 Management

14.1.3.1 Nonoperative

The nonoperative management of extraperitoneal bladder rupture is the standard treatment for patients that present with uncomplicated extraperitoneal bladder injuries [3, 7, 8]. Almost all blunt extraperitoneal bladder ruptures can be treated nonoperatively. Nonoperative management consists of continuous bladder drainage with a catheter, antibiotic prophylaxis, and clinical observation [3].

Orthopedic surgeons often choose to stabilize pelvic fractures with open reduction and internal fixation. Extraperitoneal bladder injuries should be repaired while pelvic fractures are surgically treated to reduce the risk of infection [3, 4]. If laparotomy is performed to treat another abdominal injury in patients with extraperitoneal bladder rupture, latter complications can be avoided if the bladder injury is sutured during the same operation [7].

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