One evening the girl was at her friend's birthday party at a local bar and drank several mugs of beer. Returning home, she stumbled over the curb and fell face down on the sidewalk, hitting hard. As she rose, she felt a pain in her chest and found a small dissection of the skin on her chin. At home, the girl tried to urinate, but the volume of excreted urine was very small in comparison with the amount of beer drunk.
Sore with breathing
At night the girl woke up with a pain in her stomach. The pain was not strong, and the girl even could fall asleep again, but by the morning the painful sensations had greatly increased. In addition, it became difficult and painful to breathe. The girl decided to go to the emergency room.
Basic indicators of vital functions
The trauma doctor examined the patient's chest. Visible damage, he did not find, but drew attention to soreness and some bloating. On the inside of the thighs. On the roentgenogram of the chest (designated to exclude fractures of the ribs) and pelvic organs, there were no abnormalities. In the emergency room, the doctor examined the girl, noting the pain and swelling of the abdomen. The patient's urine was analyzed.
Additional research
The girl managed to collect urine for analysis. In the urine, traces of blood were found, so the doctor suspected a rupture of the bladder as a result of the fall. A test was performed to detect free fluid in the abdominal cavity: a thin needle was used for this patient under local anesthesia (this procedure is called abdominal puncture) through the anterior abdominal wall. The extracted liquid had a slight odor of urine, so the patient was referred for consultation to a gynecologist.
Confirmation of diagnosis
Gynecologists have scheduled a cystography (in this procedure, a radiopaque substance is inserted into the bladder via a catheter). The X-ray showed that the fluid flows into the abdominal cavity, which confirmed the assumption of a bladder rupture. A decision was made on surgical treatment.
Operation
During the operation, the bladder rupture was bruised. A thin drainage tube was installed in the abdominal cavity in two days to remove residual free liquid. In the bladder, a permanent catheter was inserted through the urethra, with which the urine had to flow into the urine receiver fixed on the leg for 10 days. Thus, permanent drainage of urine was provided for the time of healing of the wall of the bladder.
Rare case
Bladder ruptures of this kind are relatively rare and may not be immediately recognized - due to the fact that for some time after the injury. That evening the girl celebrated her birthday at a local bar. On the way home, she fell. As a result, the girl had a rupture of the bladder, which at that time was filled and stretched. The victim has the urge to normal urination. However, the leakage of urine into the abdominal cavity gradually leads to protrusion of the abdomen and development of signs of peritonitis. Usually, bladder injuries are associated with urethral injuries. After the operation to close the bladder rupture, the patient was placed on the urinary catheter for 10 days. During the healing of the bladder, the urine will flow through the catheter into the urine receiver, which is fixed on the victim's leg. After the hospital, the girl recovered and was discharged.