Herniation of the Bladder into the Rectum in a Dog

Summary

In the dog, the pelvis is frequently injured following motor vehicle accidents (1). Injuries to the lower urinary and intestinal tracts may accompany pelvic fractures in man (2, 3, 4, 5) and the dog (1, 6, 7). This paper describes an unsual case of bladder retroflexion and herniation through a tear, into the rectum of a dog, following traumatic fracture of the pelvis. The successful management and repair is outlined and a biomechanical sequence leading to the abnormal bladder position is proposed.

An unusual case of bladder retroflexion and herniation through a tear, into the rectum of a dog, following traumatic fracture of the pelvis is described. Repair was accomplished by manipulation of the bladder into its normal position through a coeliotomy incision and suturing of the rectal tear after prolapsing the rectum through the anus. The proposed biomechanical sequence leading to this injury is tearing by the inwardly rotated, fractured left hemipelvis as well as or alternatively, shearing forces along lines of excessive tension.

Key words

Dog - Bladder herniation - Rectal laceration - Pelvic fracture

• References

• 1 Kolata R J, Johnston D E. Motor vehicle accidents in urban dogs: A study of 600 cases. J Am Vet Med Assoc 1975; 167: 938-41.
• 2 Berman A T, Tom L. Traumatic separation of the pubic symphysis with associated fatal rectal tear. A case report and analysis of mechanism of injury. J Trauma 1974; 14: 1060-7.
• 3 Pokorny M, Pontes J E, Pierce J M. Urological injuries associated with pelvic trauma. J Urol 1979; 121: 455-7.
• 4 Weems W L. Management of genito-urinary injury in patients with pelvic fractures. Ann Surg 1979; 189: 717.
• 5 Zannis V J, Wood M. Laparotomy for pelvic fracture. Am J Surg 1980; 140: 841-5.
• 6 Johnston D E. Rectum and anus: Surgical diseases. In: Textbook of small animal surgery. Vol 1. Slatter D H. (ed). American Veterinary Publications; 1985: 770-93.
• 7 Selcer B A. Urinary tract trauma associated with pelvic trauma. J Am Anim Hosp Assoc 1982; 18: 785-93.
• 8 Wingfield W E. Lower urinary tract injuries associated with pelvic trauma. Canine Pract 1974; 25-8.
• 9 Betts C W. Pelvic fractures. In: Textbook of small animal surgery. Vol 2. Slatter D H. (ed). American Veterinary Publications; California: 1985: 2138-53.
• 10 Fennwarth B. Schwere Beckenfraktur mit Rektumabriß und Verblutungsstad. Zbl Chir 1971; 5: 190-2.
• 11 Greiner T P, Greene R W, Archibald J. Rectum and anus. In: Canine and Feline Surgery. Vol. 1. Archibald J, Catcott E J. (eds). American Veterinary Publications; 1984: 205-47.
• 12 Freeark R. The abdomen in the patient with multiple injuries. Can J Surg 1982; 25: 178-80.
• 13 Spear C V, Hollins G G, Thiemeyer J S, Masow J A, Williamson S R, Neff R S. Vascular and adjacent soft tissue injuries associated with fractures of the pelvis. South Med J 1975; 68: 142-4.
• 14 Hauptman J, Hurd D. Herniation of the urinary bladder and diaphragmatic hernia in a cat. J Am Vet Med Assoc 1978; 172: 164-5.
• 15 Gambardella P C, Archibald J. Urinary system. In: Canine and feline surgery. Vol 1. Archibald J, Catcott E J. (eds). American Veterinary Publications; California: 1984: 357-452.
• 16 Evans H E, Christensen G C. Urinary bladder and the male genital organs. In: Miller’s Anatomy of the dog. 2nd edn.. Evans H E, Christensen G C. (eds). W B Saunders Company; Philadelphia: 1979: 552-80.
• 17 Smuts M M S. Department of Anatomy; Onderstepoort, South Africa: Personal Communication. 1989
• 18 White R A S, Herrtage M E. Bladder retroflexion in the dog. J Small Anim Pract 1986; 27: 735-46.
• 19 De Novo R C. Therapeutics of gastrointestinal disease. In: Current Veterinary Therapy. Vol IX. Krik R W. (ed). W B Saunders Company; Philadelphia: 1986: 862-72.