과음 후 발생한 자발성 방광파열 1예

• Published in: The Korean journal of medicine pp. 370 - 373
• Main Authors: 이명하, 정준영, 백대현, 박영숙, 유탁근, 성수아, 황영환
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.03.2009
• Subjects: 내과학
• ISSN: 1738-9364; 2289-0769

자연 방광파열은 매우 드물지만 조기에 진단하지 못하면 치명적인 합병증을 유발할 수 있으므로 알코올 섭취의 병력과 복통, 원인 불명의 복수, 핍뇨성 신부전의 양상을 보이는 환자에서 방광파열도 감별진단에 포함하여 복수 크레아티닌 검사를 시행하고 의심이 되면 확진 및 수술로 예후의 향상을 가져올 수 있겠다. Spontaneous urinary bladder rupture is uncommon, but is associated with significant morbidity and mortality because of delayed diagnosis. A 65-year-old man was admitted to the emergency room because of low abdominal pain and abdominal distention of sudden onset. The previous night, he had consumed a bottle of alcohol and fallen asleep. Diagnosed as peritonitis of unknown origin, he was prescribed antibiotics empirically. However, the ascites progressed and oliguric acute renal failure developed. On the fifth day, we measured the creatinine level in the ascitic fluid and performed retrograde cystography. He was diagnosed as idiopathic spontaneous bladder rupture and underwent a primary repair successfully. When a patient presents with acute abdominal pain, ascites, and oliguric acute renal failure without definite causes, physicians should consider idiopathic spontaneous bladder rupture, measure the creatinine level in the ascitic fluid immediately, and perform retrograde cystography to obtain an early diagnosis. KCI Citation Count: 5