The Korean Journal of Medicine

  • 제83권2호
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  • Pages.254-257
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  • 2012
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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당뇨병성 신경인성 방광 환자에서 복막 도관 삽입으로 발생한 방광 천공

Iatrogenic Bladder Perforation During Catheter Implantation for Peritoneal Dialysis in a Patient with Diabetic Neurogenic Bladder

  • 최윤정 (영남대학교 의과대학 내과학교실) ;
  • 도준영 (영남대학교 의과대학 내과학교실) ;
  • 박종원 (영남대학교 의과대학 내과학교실)
  • Choi, Yoon-Jung (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Do, Jun-Young (Department of Internal Medicine, Yeungnam University College of Medicine) ;
  • Park, Jong-Won (Department of Internal Medicine, Yeungnam University College of Medicine)
  • 발행 : 2012.08.01
⟨ 이전 논문 다음 논문 ⟩

초록

복막 도관의 삽입 과정 중 드물게 방광 천자가 발생할 수 있으며, 신경인성 방광이 발생할 수 있는 당뇨병 환자에서는 특별히 주의를 기울여야 할 것으로 생각된다. 맹시술법에 의한 복막투석 도관 삽입으로 인한 복막내 방광 파열 후 복막염이나 패혈증의 증거가 없어서, 도뇨관 유치 및 예방적 항생제 사용 등의 보존적 치료로 성공적으로 치료한 예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

We report herein a case of iatrogenic intraperitoneal bladder perforation during catheter implantation for peritoneal dialysis (PD) in a patient with neurogenic urinary bladder. A 63-year-old man with diabetes and end-stage renal disease due to ischemic acute kidney injury was admitted for PD catheter implantation. After the procedure, the drained dialysate volume was less than the infused dialysate volume, and the remainder was drained through the urethral catheter. Intraperitoneal bladder perforation was confirmed by retrograde computed tomographic cystography. Because the PD catheter was removed, the patient was treated with urethral catheter drainage and prophylactic antibiotics. Fourteen days after PD catheter removal, voiding cystourethrography was performed. There were no signs of extravasation, and the integrity of the bladder was confirmed.

키워드

참고문헌

  1. Moist LM, Port FK, Orzol SM, et al. Predictors of loss of residual renal function among new dialysis patients. J Am Soc Nephrol 2000;11:556-564.
  2. Tiong HY, Poh J, Sunderaraj K, Wu YJ, Consigliere DT. Surgical complications of Tenckhoff catheters used in continuous ambulatory peritoneal dialysis. Singapore Med J 2006;47:707-711.
  3. Peppelenbosch A, Kuij KW, Bouvy ND, Sande FM, Tordoir: Peritoneal dialysis catheter placement technique and complications. NDT Plus 2008;1(Suppl 4):iv23-iv28.
  4. ESRD Registry Committee, Korean Society of Nephrology. Current renal replacement therapy in Korea-Insan Memorial Dialysis Registry, 2009. Korean J Nephrol 2009;28: S525-S551.
  5. Cass AS. Diagnostic studies in bladder rupture: indications and techiniques. Urol Clin North Am 1989;16:267-273.
  6. Corriere JN Jr, Sandler CM. Mechanisms of injury, patterns of extravasation and management of extraperitoneal bladder rupture due to blunt trauma. J Urol 1988;139:43-44.
  7. Pansadoro A, Franco G, Laurenti C, Pansadoro V. Conservative treatment of intraperitoneal bladder perforation during transurethral resection of bladder tumor. Urology 2002;60:682-684. https://doi.org/10.1016/S0090-4295(02)01843-5
  8. Manikandan R, Lynch N, Grills RJ. Percutaneous peritoneal drainage for intraperitoneal bladder perforations during transurethral resection of bladder tumors. J Endourol 2003; 17:945-947. https://doi.org/10.1089/089277903772036343
  9. Alperin M, Mantia-Smaldone G, Sagan ER. Conservative management of postoperatively diagnosed cystotomy. Urology 2009;73:1163. e17-e19. https://doi.org/10.1016/j.urology.2008.03.047
  10. Chung BC, Choi CI, Kim KW, et al. Diagnosis of urinary bladder dysfunction by radionuclide urodynamic study in patients with diabetes mellitus. Korean J Med 1992;42: 306-314.