{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:52:22Z","timestamp":1761238342366},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T00:00:00Z","timestamp":1478736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acute Medicine &amp; Surgery"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>Bladder ruptures are commonly misdiagnosed as gastrointestinal perforations or intestinal ischemia. If a diagnosis is made preoperatively, conservative treatment is a safe and effective option. We evaluated the validity of using the attenuation value of ascites, measured by non\u2010contrast computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), to identify patients with bladder ruptures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective search of our hospital database identified 7 patients with confirmed bladder ruptures between 2007 and 2013. We also enrolled 18 patients with gastrointestinal perforations and 10 patients with intestinal ischemia with detectable ascites on abdominal <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> that had undergone emergency exploratory laparotomy between 2007 and 2013. Between\u2010group comparisons of attenuation values of ascites as obtained by non\u2010contrast <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All attenuation values were less than 10 Hounsfield units (<jats:styled-content style=\"fixed-case\">HU<\/jats:styled-content>) in bladder rupture patients. Moreover, the attenuation value of ascites in cases of bladder rupture (median, 5.7; range, 3.1\u20136.1) was significantly lower than in cases of gastrointestinal perforation (median, 14.7; range, 4.7\u201325.4) and intestinal ischemia (median, 13.3; range, 6.0\u201318.1) (<jats:italic>P<\/jats:italic> = 0.004 for both comparisons).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bladder rupture mimics gastrointestinal perforation and intestinal ischemia with acute kidney injury. Therefore, the diagnosis of bladder rupture using the attenuation value of ascites on non\u2010contrast <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> is both useful and highly significant. We suggest that bladder rupture be considered in the differential diagnosis of patients presenting with acute abdominal pain and attenuation values of ascites of less than 10 Hounsfield units.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ams2.248","type":"journal-article","created":{"date-parts":[[2016,11,10]],"date-time":"2016-11-10T12:12:16Z","timestamp":1478779936000},"page":"184-189","source":"Crossref","is-referenced-by-count":7,"title":["Non\u2010traumatic bladder rupture showing less than 10 Hounsfield units of ascites"],"prefix":"10.1002","volume":"4","author":[{"given":"Naoto","family":"Mizumura","sequence":"first","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuo","family":"Imagawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayasu","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Surgery Bellland General Hospital Sakai\u2010city Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,10]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2011.10.003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)70565-4"},{"key":"e_1_2_6_4_1","first-page":"1799","volume-title":"Clinical Urography","author":"Sander CM","year":"2000"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.0971"},{"key":"e_1_2_6_6_1","first-page":"269","article-title":"Conservative management of early bladder rupture after postoperative radiotherapy for prostate cancer","volume":"5","author":"Basiri A","year":"2008","journal-title":"Urol. 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