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definition

The rupture of the bladder is defined as a rupture of the urinary bladder, which is usually accompanied by escaping urine into the surrounding areas. The medical classification of a bladder rupture occurs depending on the location of the injury.

causes

In most cases, a bladder tear occurs in connection with a pelvic fracture. Such pelvic fractures usually arise acutely due to an accident.
The reason for the rupture of the bladder lies in bone fractions that penetrate through the bladder, causing a rupture. In other cases, however, blunt trauma (for example, in a car accident by the seat belt or the steering wheel) or bruising in the abdominal area may be the cause of a bladder tear.
A spontaneous rupture of the bladder is relatively rare and may occur in patients who have previous damage from other diseases in this area. Furthermore, the blister ruptures when injuries from knives or firearms injure the lower abdomen in the bladder area.

diagnosis

In most cases, patients with suspected bladder rupture are screened using ultrasound imaging.

Bladder tear occurs more frequently after an acute injury. People who suffer from a ruptured bladder complain of very severe pain. In addition, the attending physician can diagnose the bladder tear through some procedures.
For this purpose, imaging methods are used which can also reproduce "soft" tissue structures well. Therefore, people who are suspected of having a bladder tear are usually diagnosed and diagnosed by sonography (ultrasound).
In special cases, an MRI device can also be used to confirm the diagnosis, especially if other injuries can not be ruled out.

frequency distribution

A total of three different forms of a bladder tear are distinguished. A distinction is made between the location of the tear in the muscles of the bladder. The bladder is separated from above by the peritoneum (medically: Peritoneum) from the organs located in the abdominal cavity. About 25% of the bladder cracks occur in this area. They are also called: Intraperitoneal bladder tear. This tear is often caused by a sudden increase in pressure in the lower abdominal area with a filled bladder.

In most cases, however, the bubble rupture occurs below this area. If a rupture of the bladder occurs in the part of the bladder that is not lined by the peritoneum, the diagnosis is called extraperitoneal bladder rupture. This injury is a common concomitant of a pelvic fracture and accounts for about 70% of all bladder ruptures.

Finally, one distinguishes these bubble cracks from the so-called spontaneous bubble rupture. If the bladder has already been damaged by other diseases, this form of rupture can occur. However, the frequency of this injury is below 5% of all bladder tears.

symptoms

In general, people who have a bladder tear complain of severe pain in the lower abdominal area, which can also radiate into other parts of the body, especially in the abdominal area.
Due to the rupture, blood cells enter the urine, which show up when urinating in red urine. It is also typical that the person is no longer able to hold the urine after a rupture of the bladder. Pressure sensitivity and abdominal pain are also a common symptom of a bladder tear. Typical here is the presence of a so-called "release pain". This can be tested by putting the hand deep in the abdomen and then pulling it back quickly. In the retreating movement, the affected persons feel a strong pain.
In addition, it can usually be determined by light touch that the abdomen is very hard, which is connected with a muscular system in this area which is tense due to the bladder rupture.

therapy

Intraperitoneal and severe extraperitoneal bladder ruptures usually need to be treated surgically.

The therapy of a bladder tear basically depends on where the tear is located. If there is an intraperitoneal tear (on the upper part of the bladder), the tear is treated surgically. As soon as the diagnosis is established, an operation is usually prepared in which the present bladder tear is sutured. Thereafter, a bladder catheter is used to relieve the bladder first.

If there is an extraperitoneal (in the lower part of the bladder) blistering tear, the therapy depends heavily on the severity of the injury. In the case of a severe rupture of the bladder, it must also be operated on, whereas in the case of a slight rupture, the laying of a bladder catheter is usually sufficient to relieve the bladder.

forecast

The prognosis after a blister rupture depends on many different factors. First of all, dangerous complications occur much more frequently with intraperitoneal bladder tears, as urine can enter the abdominal cavity and cause infections there.
It can also lead to urosepsis, a dangerous complication in which bacteria get into the blood.
In principle, it is important to detect a rupture of the bladder at an early stage and to initiate appropriate therapy in good time. Under these conditions, the prognosis after a blister rupture can usually be described as good.

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