動脈瘤膀胱廔管
羅浩倫
高雄長庚紀念醫院 泌尿科
Fistula between urinary bladder and internal iliac artery aneurysm
Hao Lun Luo
Kaohsiung Chan Gung Medical Center, Department of Urology
A 78 year-old gentleman suffered from low abdominal pain with hematuria for one day. He was brought to our emergency department. The physical examination revealed tachycardia and obvious low abdominal tenderness. Laboratory exam showed anemia and renal insuffieicncy. Due to progressive low abdominal dissension after urethral catheterization, abdominal CT without contrast enhancement was emergently arranged. CT revealed bladder hematoma and two adjacent large internal artery aneurysms. Then this patient presented as progressive hypotension and consciousness deterioration. Emergent laparotomy was performed and we found massive intraperitoneal bleeding originated from urinary bleeding. The bleeding was projectile from the detrusor layer of urinary bladder. After performing cystectomy, the left internal artery aneurysm bleeder was found and internal artery ligation was done smoothly.