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例1、女,55岁。尿频、尿痛伴血尿6年。静脉肾盂造影正常,尿抗酸杆菌及尿培养均阴性。膀胱镜检查:粘膜充血,多处片状溃疡及瘢痕。近10天排尿量少,下腹出现包块。1天前排尿时突然剧烈腹痛,呈持续性,从下向上蔓延。自腹痛后未再排尿。查体:全腹肌紧张、压疼,反跳痛,有移动性浊音。膀胱容量试验(+)。诊断:自发性膀胱破裂、腹膜内型。急症手术:见腹腔内淡黄色混浊液体3500ml,膀胱充盈,壁质地不均,顶部破口O.5cm,与腹腔相通。膀胱切取标本,修补破口,吸净腹腔内液体,尿道内置管引流。术后抗生素治疗。病理诊断:间质性膀胱炎并膀胱破裂。
Example 1, female, 55 years old. Urinary frequency, dysuria with hematuria 6 years. Intravenous pyelography was normal, urine acid-fast bacilli and urine culture were negative. Cystoscopy: mucosal congestion, multiple ulcers and scars. Less urine output over the past 10 days, lower abdomen appeared mass. Suddenly severe abdominal pain during urination 1 day ago, was persistent, spread from the bottom up. No urination after abdominal pain. Physical examination: the whole abdominal muscle tension, tenderness, rebound tenderness, a moving dullness. Bladder volume test (+). Diagnosis: Spontaneous bladder rupture, intraperitoneal. Emergency surgery: see the intra-abdominal light yellow turbid liquid 3500ml, bladder filling, uneven wall texture, the top of the hole O.5cm, and the abdominal communication. Bladder cut specimens, repair break, suction net intraperitoneal fluid, urethral catheter drainage. Postoperative antibiotic treatment. Pathological diagnosis: interstitial cystitis and bladder rupture.