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Bladder rupture is divided into intraperitoneal and extraperitoneal rupture, with the latter encompassing 85% of post-traumatic bladder rupture. Intraperitoneal rupture is both more rare and associated with greater morbidity, requiring surgical repair due to the risk of non-healing and gram negative sepsis. [6] [7]
In 90% of bladder injuries, there is a concurrent pelvic fracture. [1] Pelvic bone fragments penetrate and perforate the bladder. [1] Perforations can be either extraperitoneal or intraperitoneal. [1] Intraperitoneal perforations allow for urine to enter the peritoneal cavity. Symptoms typically develop immediately if the urine is infected. [1]
Bile, pus, or blood released from viscera anywhere along its length may run along the paracolic gutter, and collect in sites quite remote from the organ of origin. [2] In supine patients, infected fluid from the right iliac fossa may ascend in the paracolic gutter to enter the lesser sac.
The structures within the intraperitoneal space are called "intraperitoneal" (e.g., the stomach and intestines), the structures in the abdominal cavity that are located behind the intraperitoneal space are called "retroperitoneal" (e.g., the kidneys), and those structures below the intraperitoneal space are called "subperitoneal" or ...
Intraperitoneal bladder rupture will present with upper abdominal pain and referred pain to the shoulder. Extraperitoneal bladder rupture may present with inguinal, peri-umbilical pain. TURP syndrome : Hyponatremia and water intoxication caused by an overload of fluid absorption from the open prostatic sinusoids during the procedure. [ 9 ]
Extraperitoneal fascia (also: endoabdominal fascia or subperitoneal fascia) is a fascial plane – consisting mostly of loose areolar connective tissue – situated between the fascial linings of the walls of the abdominal and pelvic cavities (transversalis fascia, anterior layer of thoracolumbar fascia, iliac fascia, and psoas fascia) externally, and the parietal peritoneum internally.
The retropubic space is a surgical landmark that has surgical significance in several gynecological and urological procedures. Access to the space is achieved by separating the rectus abdominis muscle at the mid line, and bluntly dissecting the tissue in the direction of the symphysis pubis, until reaching the peritoneum.
Peritoneal recesses (or peritoneal gutters) are the spaces formed by peritoneum draping over viscera. [1] The term refers mainly to four spaces in the abdominal cavity; the two paracolic gutters and the two paramesenteric gutters. There are other smaller recesses including those around the duodenojejunal flexure, cecum, and the sigmoid colon.