Zusammenfassung
Bei einem 74-jährigen Patienten kam es während der transurethralen Resektion (TUR) eines Blasentumors an der Vorderwand zur Knallgasexplosion in der Blase mit Zerreißung der Blasenvorderwand. Die Computertomographie (CT) zeigte zahlreiche verstreut liegende Gasbläschen im perivesikalen Bereich. Die Behandlung erfolgte konservativ.
Intravesikale Explosionen entstehen, wenn der durch TUR freigesetzte Wasserstoff sich mit Außenluft vermischt und dann durch Funkenschlag gezündet wird. Zur Prophylaxe muss eine Elektroresektion mit Kontakt zur Luftblase vermieden werden.
Abstract
A 74-year-old patient underwent transurethral electroresection for a bladder tumor located at the anterior wall close to the air bubble. Intraoperatively, an explosion occurred. Computed tomography documented laceration of the anterior bladder wall with numerous small gas bubbles dispersed in the perivesical area. The etiology of intravesical explosions is based on formation of hydrogen during electroresection.
Hydrogen by itself is not explosive; a blast will occur only when atmospheric oxygen is admixed and then ignited by sparks from electroresection. To prevent such a complication, care must be taken not to activate the resection loop within the air bubble of the bladder.
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Dieckmann, KP., Gehrckens, R. & Biesewig, AK. Blasenperforation durch intravesikale Knallgasexplosion. Urologe 47, 860–862 (2008). https://doi.org/10.1007/s00120-008-1718-1
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DOI: https://doi.org/10.1007/s00120-008-1718-1