Urgent Transurethral Resection of a Massive Bladder Clot in a Hemodynamically Unstable Patient

Abdelmounim Boughaleb, Reda Tariqi, Ilyas Soufiani, I. Boualaoui, Ahmed Ibrahimi, H. E. Sayegh, Yassine Nouini
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Abstract

This case report describes a 58-year-old male with a history of chronic smoking who presented with severe hematuria and hemodynamic instability. Initial assessment revealed a massive bladder clot and critically low hemoglobin. Despite initial interventions, the patient suffered cardiac arrest requiring prolonged resuscitation. Emergency cystoscopy was performed, removing a 320-gram clot and resecting a 2 cm bladder tumor. Despite successful surgical intervention and post-operative intensive care, the patient succumbed to multi-organ failure six days later. This case highlights the potential severity of hematuria and the importance of prompt diagnosis and treatment of underlying causes. It also demonstrates the challenges in managing complex cases involving massive hemorrhage, hemodynamic instability, and the sequelae of prolonged cardiac arrest.
紧急经尿道切除血流动力学不稳定患者的大量膀胱血块
本病例报告描述了一名有长期吸烟史的 58 岁男性,因严重血尿和血流动力学不稳定而就诊。初步评估显示,患者膀胱内有大量血块,血红蛋白极低。尽管采取了初步干预措施,但患者仍出现心脏骤停,需要长时间抢救。患者接受了紧急膀胱镜检查,取出了 320 克的血块,并切除了一个 2 厘米的膀胱肿瘤。尽管手术干预和术后重症监护取得了成功,但六天后患者还是死于多器官衰竭。这个病例突出了血尿的潜在严重性以及及时诊断和治疗潜在病因的重要性。该病例还显示了处理涉及大量出血、血流动力学不稳定和长时间心脏骤停后遗症的复杂病例所面临的挑战。
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