IJU case reports · 2025
A Case of Bladder Perforation With Rectal Impalement Injury.
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Juichi Tatsuma, Fujikawa Atsushi
Аннотация
INTRODUCTION: Combined rectal impalement (RI) and bladder perforation (BP) is an extremely rare injury pattern, with limited case reports and no established consensus on their diagnosis and management.
CASE PRESENTATION: A 50-year-old man sustained a perianal impalement injury caused by a metal rod at a construction site. He presented with perianal pain and gross hematuria (GH). Imaging revealed RI and extraperitoneal BP. A colostomy was performed on the same day as the injury, and transurethral coagulation of the bladder (TUC) was performed on the 6th day, during which a bladder mucosal defect was identified. Postoperatively, the GH reduced, and no persistent voiding or defecation dysfunction was observed.
CONCLUSION: In patients with RI and GH, concomitant BP should be suspected. Although colostomy is almost always required for rectal injury, extraperitoneal BP can be cured with transurethral intervention and catheterization.
CASE PRESENTATION: A 50-year-old man sustained a perianal impalement injury caused by a metal rod at a construction site. He presented with perianal pain and gross hematuria (GH). Imaging revealed RI and extraperitoneal BP. A colostomy was performed on the same day as the injury, and transurethral coagulation of the bladder (TUC) was performed on the 6th day, during which a bladder mucosal defect was identified. Postoperatively, the GH reduced, and no persistent voiding or defecation dysfunction was observed.
CONCLUSION: In patients with RI and GH, concomitant BP should be suspected. Although colostomy is almost always required for rectal injury, extraperitoneal BP can be cured with transurethral intervention and catheterization.