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      Nontraumatic urinary bladder rupture presenting as renal pseudo-failure and ascites

      case-report
      , MD a , , , MD a , , MD b , , MD a
      Radiology Case Reports
      Elsevier
      Bladder rupture, Ascites, Renal failure, Urology

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          Abstract

          A 24-year-old man, with past medical history significant only for nocturnal enuresis until the age of 12 years, presented to the emergency department with acute abdominal pain after an episode of difficulty with micturition in the middle of the night. On presentation, physical examination was suggestive of ascites and laboratories revealed an elevated serum creatinine of 1.88 mg/dL. He was subsequently found to have a ruptured bladder, without any inciting trauma, which required surgical repair. His only surgical history is an unknown, apparently urologic, surgery when he was 11-12 years old. The patient's unique presentation prompts discussion of bladder rupture and its manifestations, the role of clinical information in informing imaging protocol, and the importance of sagittal images in identifying pathology.

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          Most cited references17

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          Congenital anomalies of the male urethra

          The spectrum of congenital anomalies of the male urethra is presented. The embryologic basis of each anomaly, when known, is discussed. Clinical and imaging features of each entity are presented.
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            Primary Nocturnal Enuresis: A Review

            Context Nocturnal enuresis or bedwetting is the most common type of urinary incontinence in children. It has significant psychological effects on both the child and the family. Enuresis nocturna is defined as the inability to hold urine during the night in children who have completed toilet training. It is termed as being “primary” if no continence has ever been achieved or “secondary if it follows at least 6 months of dry nights. The aim of this review was to assemble the pathophysiological background and general information about nocturnal enuresis. Evidence Acquisition This review was performed by evaluating the literature on nocturnal enuresis published between 1970 and 2015, available via PubMed and using the keywords “nocturnal enuresis,” “incontinence,” “pediatric,” “review,” and “treatment.” Results Children with nocturnal enuresis produce urine at higher rates during the night, and may have lower bladder capacities. Some children with nocturnal enuresis may also have daytime urgency, frequency, and urinary incontinence. Treatment includes aggressive treatment of accompanying constipation or urinary tract infections, behavioral changes, and medical therapy. Alarm therapy remains the first-line treatment modality for primary nocturnal enuresis. High rates of patient compliance and relapse mean that alternative treatments remain on the agenda. Conclusions Nocturnal enuresis is a common problem that has multifaceted effects on both the child and the family. Due to multiple etiologic factors, nocturnal enuresis is still not clearly defined.
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              Evaluating the Role of Operative Repair of Extraperitoneal Bladder Rupture Following Blunt Pelvic Trauma.

              Catheter drainage has become a standard management strategy for extraperitoneal bladder rupture from blunt trauma. However, data are lacking critically comparing outcomes between operative and nonoperative management. In this study we evaluate management strategies and identify risk factors for complications.
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                Author and article information

                Contributors
                Journal
                Radiol Case Rep
                Radiol Case Rep
                Radiology Case Reports
                Elsevier
                1930-0433
                07 April 2017
                June 2017
                07 April 2017
                : 12
                : 2
                : 304-307
                Affiliations
                [a ]Department of Internal Medicine, University of Maryland Medical Center, Midtown Campus, 827 Linden Avenue, Baltimore, MD 21201, USA
                [b ]Division of Urology, Department of Surgery, University of Maryland Medical Center, Midtown Campus, Baltimore, MD, USA
                Author notes
                [] Corresponding author. Andrew.Mark.MD@ 123456gmail.com
                Article
                S1930-0433(17)30015-8
                10.1016/j.radcr.2017.03.005
                5417767
                28491176
                64b57b40-ec13-41ef-9373-0529342e57da
                © 2017 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 14 January 2017
                : 5 March 2017
                : 6 March 2017
                Categories
                Case Report

                bladder rupture,ascites,renal failure,urology
                bladder rupture, ascites, renal failure, urology

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