Abstract
There is a consensus that blunt traumatic intraperitoneal bladder rupture should undergo water-tight suturing and be decompressed by a transurethral catheter. This is the first report of the non-operative management of blunt traumatic intraperitoneal bladder rupture with a severe pelvic fracture. A 32-year-old male was run over by a power shovel, and brought to our emergency department. Upon arrival, he was in severe shock because of massive bleeding from a severe pelvic fracture. Transcatheter arterial embolization and an external fixation for the pelvic fracture was performed. Retrograde cystography showed an intraperitoneal bladder rupture. On the day of admission, the non-operative management of the intraperitoneal bladder rupture was performed to prevent additional bleeding. We could continue the conservative management on the day after admission because urine could be constantly drained. At one week after admission, the bladder rupture healed. The non-operative management for an intraperitoneal bladder rupture with a severe pelvic fracture is an important treatment modality in order to carry out damage control after a severe pelvic fracture. Such non-operative management can be continued when a celiotomy is not needed for other abdominal organ injuries, no intravesical bone spicule is detected, and urine can be constantly drained.
