BMJ的病例报告长什么样子？27岁年轻女性游乐场里突发膀胱破裂

病例报告往往是少见或者经典病例的报告。在我们泱泱大国，最不缺的就是病例。大家在临床工作中，需要善于发现，善于总结，善于发表。今天我们看看殿堂级医学期刊，BMJ医学杂志的病例报告长什么样子。

27岁年轻女性，在露天游乐场，有过短暂晕厥后，突感腹部疼痛。没有明确的外伤史。实验室检查提示急性肾功能损伤，予以导尿。腹部CT平扫提示大量腹腔积液，诊断性腹腔穿刺提示腹膜内膀胱破裂。提示如果腹腔内大量游离液体，同时出现急诊肾功能损伤，应该考虑腹膜内膀胱破裂。当膀胱充盈时，即使再小的创伤也可以引起膀胱破裂。

A 27 year old woman presented with acute abdominal pain after a brief syncope while on a fairground ride. She reported no history of serious trauma. Because blood tests showed acute renal impairment a urinary catheter was inserted. Unenhanced computed tomography showed gross intraperitoneal free fluid with no clear cause. Diagnostic laparoscopy identified intraperitoneal bladder rupture, which required open surgical repair. Even in the absence of a clear history of trauma, the presence of a large volume of free fluid and acute renal impairment should raise suspicion of intraperitoneal bladder rupture. This can occur with minimal trauma when the bladder is full. Surgical repair offers an excellent outcome.

注：文献来源以及图片来源：BMJ 2015;352:h6664 doi: 10.1136/bmj.h6664 (Published 6 January 2016)

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