Bladder tear

definition

Of the Bladder tear is defined as a crack of the bladderwhich is usually associated with leaking urine into the surrounding areas. The medical classification of a ruptured bladder is based on the location of the injury.

causes

In most cases, a bladder tear is associated with a Pelvic fracture on. Such pelvic fractures are usually acute as a result of an accident.
The reason for the rupture of the bladder lies in Bone partswhich penetrate the bladder, causing a rupture. However, in other cases blunt trauma (for example in a car accident through the seat belt or the steering wheel) or Bruises be the cause of a ruptured bladder in the abdomen.
A spontaneous rupture of the bladder is relatively rare and can occur in patients who have had other diseases in the area Previous damage Suffer. Furthermore, the bladder ruptures when injuries from knives or firearms injure the lower abdomen in the area of ​​the bladder.

diagnosis

A bladder tear occurs after one acute injury on. People with a ruptured bladder complain of very severe pain. In addition, the attending physician can diagnose the bladder tear through a number of procedures.
Be for this imaging procedures which can also reproduce “soft” tissue structures well. Therefore, people who are suspected of having a ruptured bladder will in most cases also Sonography (Ultrasound) examined and diagnosed.
In special cases, a MRIDevice can be used to back up the diagnosis, especially when other injuries cannot be ruled out.

Frequency distribution

There are three different types of bladder tear. A distinction is made here, Where the tear is in the muscles of the bladder. The bladder is drawn from above through the Peritoneum (medical: peritoneum) separated from the organs in the abdominal cavity. About 25% of bubble cracks take place in this area. They are then also called: Intraperitoneal Bladder tear. This tear often results from a sudden increase in pressure in the lower abdomen when the bladder is full.

In most cases, however, the bladder rupture occurs below this area on. If a bladder rupture occurs in the part of the bladder that is not lined by the peritoneum, the diagnosis is: Extra peritoneal Bladder tear. This injury is a common accompaniment to one Pelvic fracture and accounts for about 70% of all blister cracks.

Finally, one differentiates between these bladder tears and the so-called spontaneous bladder tears. If the bladder has already been damaged by other diseases, this type of rupture can occur. However, the frequency of this injury is less than 5% of all bladder tears.

Symptoms

In general, people who have a ruptured bladder complain of severe pain in the lower abdominal areawhich, however, also in other parts of the body radiate can, especially in the abdominal area.
Get through the crack Blood cells in the urine, which is in red urine demonstrate. It is also typical that the affected person is no longer able to hold the urine after a bladder rupture. Tender tenderness and pain in the abdomen are also common symptoms of a ruptured bladder. Typical here is the presence of a so-called "Pain of letting go". This can be tested by pressing the hand deep into the abdomen and then quickly withdrawing it. During the retreating movement, those affected feel severe pain.
By gently touching it can usually also be seen that the stomach very hard is what is related to tense muscles in that area due to the ruptured bladder.

therapy

The treatment of a bladder tear basically depends on where the tear is located. Is there a intraperitoneal Crack in front (on the upper part of the bladder), the crack becomes operational treated. As soon as the diagnosis is established, an operation is usually prepared in which the existing bladder tear is sutured. After that, a Urinary catheter used, which should initially relieve the bladder.

When a extraperitoneal (in the lower part of the bladder) if there is a rupture of the bladder, the therapy depends heavily on the severity of the injury. If the bladder ruptures severely, this must also be done operated on whereas a slight rupture usually involves laying one Urinary catheter sufficient to relieve the bladder.

forecast

The prognosis after a bladder rupture depends on many different factors. First of all, dangerous complications are much more common intraperitoneal Cracked bladder because of urine into the abdominal cavity get there and there Infections can trigger.
It can also become a Urosepsis come, a dangerous complication in which bacteria get into the blood.
In principle, it is important to have a bladder tear early to recognize and initiate appropriate therapy in good time. Under these conditions, the prognosis after a bladder rupture can usually be described as good.