#Bladder rupture

[ijcimr]

Combined cervical laceration and bladder rupture: a case report of an unusual complication of precipitated labor by Dr Fatemeh Darsareh in International Journal of Clinical Images and Medical Reviews 

Abstract

Cases of bladder rupture have been rarely reported following vaginal childbirth. To the best of our knowledge, however, no cases of combined cervical laceration and bladder rupture have been reported to date. We present the first case of a 31-year-old woman with gestational diabetes who suffered a combined cervical laceration and bladder rupture after childbirth. Precipitated labor caused by oxytocin induction resulted in vaginal and cervical lacerations. The bladder rupture was confirmed by cystography. A team of obstetricians and urologists performed the laparotomy. The patient was kept under observation for two weeks before being discharged with no serious complications.

Keywords: Bladder rupture; Cervical lacerations; Precipitated labor; Childbirth trauma; Case report.

Introduction

Spontaneous bladder rupture following normal vaginal delivery is a surgical postpartum emergency. Previous cesarean section, vacuum/forceps-assisted vaginal deliveries, and distended bladder compressed by engaged head in birth canal are all risk factors for bladder injuries in healthy parturient women 1. Cases of bladder rupture, accompanied by uterine rupture, have been rarely reported following vaginal birth after cesarean section 2. To the best of our knowledge, however, no cases of combined cervical laceration and bladder rupture have been reported to date. We present the first case of spontaneous bladder rupture with cervical laceration after a precipitated vaginal delivery.

Case Presentation

A 31-year-old, G2P1L0D1, woman with gestational diabetes, was admitted to our maternity ward at 38 weeks of pregnancy for elective induction of labor to terminate her pregnancy.  She had a history of preterm birth and was a known case of minor thalassemia. The induction of labor began at 5:00 a.m. with oxytocin, and contractions began approximately two hours later. Table 1 depicts the progress of labor. During her labor, the patient urinated once. Finally, at 10:40 a.m., she gave birth to a baby boy weighing 3700 grams with an Apgar score of 7/9.  Excessive vaginal bleeding was observed following placental expulsion. The examination revealed an extensive laceration in the vagina and cervix that was repaired by the obstetrician and midwife. The patient was catheterized and was being closely monitored. A urologist was consulted due to the oliguria and hematuria (100 cc output with gross hematuria within 5 hours of childbirth). Cystography, as recommended by the urologist, revealed the bladder rupture. The patient was prepared for a laparotomy immediately. The laparotomy was performed by a team of obstetricians and urologists. Several hematomas were discovered in the uterine body and the broad ligament that the team decided not to manipulate because it did not grow during the surgery. A bladder rupture was found at the dome of bladder that was repaired in two layers. One pack cell unit and two FFP units were transfused. A peritoneal drain was placed posterior to the bladder and the skin incision was closed in layers. The patient was observed for two weeks. The result of the ultrasound revealed the shrinking of the hematoma. The blood and renal tests were normal. The catheter was removed after 2 weeks and the patient was discharged.

Table 1: The progress of labor

Discussion

Precipitate labor is defined as the expulsion of the fetus within three hours of the start of contractions. Few studies have found that precipitated labor is harmful to both the mother and the newborn. Precipitated labor, which is most commonly associated with placental abruption and induction of labor, is a significant risk factor for maternal complications 3. Maternal morbidities reported included extensive birth canal lacerations, uterine rupture, placenta retention, the need for revision of uterine cavity, post-partum hemorrhage, and blood transfusions 3,4. The lower urinary tract's anatomic proximity to the reproductive tract predisposes it to iatrogenic injury during obstetric procedures. The bladder and lower ureter are two of the most commonly involved organs. Because the dome of the bladder is the weakest area, most bladder ruptures occur through the peritoneal cavity 5. In our case, in addition to deep vaginal tears and extensive cervical laceration, bladder rupture occurred, but the diagnosis was delayed by a few hours. Given the nonspecific clinical features of bladder rupture, the diagnosis should be approached with caution. Oliguria and gross hematuria after a traumatic childbirth increase the likelihood of bladder rupture. In such cases, a cystogram is thought to be the best method for early detection.

In our case the patient had induced labour with oxytocin. The use of oxytocin to induce labour can result in tachy-systole and thus shorter deliveries. So in our case we believe that the power of uterine contractions and quick descent of passenger (3700 grams fetus) were the main risk factors of precipitated labour and the complications accompanied with it. A distended bladder during labor, particularly in our case, where the fetus descended quickly, could also be a factor in bladder rupture. Although the patient urinated normally during labor, it was critical to ensure that the bladder was empty, especially during the active phase of labor, to avoid bladder damage.

CONCLUSIONS

Bladder and cervical rupture should be considered, after precipitated vaginal delivery. When there is gross hematuria, a urinary catheter should be inserted to monitor the hematuria and urine output. If the hematuria persists and other associated symptoms appear, cystography is a useful tool for determining the severity of the bladder injury and determining the cause.

Funding

This study received no specific funding from public, commercial, or not-for-profit funding agencies.

Conflict of Interest

Authors had no conflicts of interest to declare.

Patient consent

Obtained.

For more details: https://ijcimr.org/editorial-board/ 

[evo-is-obsessed]

why does philza minecraft look like ancient astronomer Tycho Brache?

[vettelcore]

i was already having a tough day at the gym and i just got told the cat we hospitalised this morning had to be put down :(

[constipated-gay]

who would win:

renowned astronomer and mentor of THE Johannes Kepler

or

piss. literally just piss.

[yrfemmehusband]

Female reproductive health terms you should know!

(terfs not welcome)

Dysmenorrhea: Period pain that isn't normal, i.e. any pain more than Mild cramping.

Dyspareunia: painful intercourse

Oligomenorrhea: lighter, shorter menstrual flow.

Menorrhagia: heavier, longer menstrual flow.

Ovarian cysts: a mass on or in one's ovary, can be resolved on its own, or can remain and cause complications such as a rupture.

Polycystic ovary syndrome: a chronic condition causing cysts to reoccur on the ovaries and enlarging them. Symptoms include:

Irregular periods

hormonal imbalance

facial hair

weight gain

painful periods/ ovulation

infertility

People with PCOS are at higher risk for endometrial cancer, type II diabetes heart problems and high blood pressure.

Endometriosis: A chronic condition in which a tissue similar to, but different than, the endometrial lining grows outside of the uterus instead of inside. During menstruation this tissue sheds and has nowhere to go, thus irritating surrounding organs.

Symptoms include:

Irregular periods

Dysmenorrhea

Widespread pain

Painful ovulation

Vomiting, fainting, chills, sweating, fever and brain fog during menstruation

Infertility

Severe bloating

This also puts people at a higher risk for endometrial and ovarian cancer. There are four stages to Endo as it is a progressive disease, with 3/4 being more severe. The average time it takes to be diagnosed is 7 years.

Adenomyosis: A chronic disease similar and comorbid to endometriosis in which a tissue similar to the endometrial lining grows inside of the uterine wall. Symptoms are nearly identical to endometriosis but more difficult to detect.

Many people are diagnosed post menopause, by fault of the medical system, but it can and does develop much before then.

Ovarian cancer: cancer of the ovary(ies).

Endometrial cancer: cancer of the endometrium, the inner lining of the uterus.

Endometrial cyst, or chocolate cyst: cystic lesions from endometriosis.

Tilted uterus: the uterus is positioned pointing towards the back or severely to the front of the pelvis instead of a slight tilt towards at the cervix. Can cause painful sex and periods.

Pelvic floor dysfunction: inability to control your pelvic muscles. Comorbid with many things and is highly comorbid with endometriosis. Can cause pain and incontinence.

Vulvodynia: chronic and unexplained pain at the opening of the vagina.

Interstitial cystitis: a chronic condition where cysts form on the inside of the bladder and urinary tract and cause symptoms similar to that of a UTI.

Pre-eclampsia: a condition occurring in pregnancy where the blood supply between the fetus and the pregnant person is affected and can cause irregular blood pressure, swelling, and in more severe cases headache, nausea and vomiting, a burning sensation behind the sternum, shortness of breath and potentially death if untreated.

Endometritis: an infection or irritation of the uterine lining. Is not the same as endometriosis and is treatable but can cause pain, bleeding, swelling, general discomfort and fever, and more.

Pelvic inflammatory disease: an infection of the reproductive organs

Ectopic pregnancy: a pregnancy that is attached to the outside of the uterus. Can be fatal if left untreated.

There are many more I could probably add but if you see something missing, please add it!

[gavisuntiedboot]

I absolutely love your writing

Could you please write for Gavi taking care of reader after a surgery and like it really hurts

Even if it’s just a blurb I’d really appreciate it (I’m fucking dying right now)

Stitches

"Hermosa, can you please just eat something? Your appendix isn't going to grow back on an empty stomach."

You wanted to laugh at Gavi's naivety, but the pain in your side was stabbing at you, making every breath a laborious task. It hurt to do anything, and the pain in your torso and head made it hard to stay conscious, let along sit up and eat the food your loving boyfriend was trying to spoon-feed you.

"They took out my gallbladder, Pablito, not my appendix." You punctuated your sentence with a groan. You tried to keep your breathing as shallow as possible to avoid the punishment that came with deep breaths. You placed a hand gently at your surgery site, trying not to apply too much pressure at the risk of rupturing your stitches.

"Whatever they removed, you need to take care of yourself so that it can grow back properly."

You grinned once more, Gavi's ignorance endearing and sweet, brightening your gloomy couple of days.

"Gallbladders don't grow back. I just have to live without it now."

Pablo almost dropped the tray in his hands. His eyes were as wide at dinner plates, in shock like you had just told him about the death of his dog.

"How are you going to be able to pee if you don't have a bladder?"

You couldn't hold back your laughter at this. You doubled over, laughing loudly and gripping your stitches that were biting into your flesh. The pain was nauseatingly intense, but you laughed nonetheless, tears falling from yours eyes as you let your soul be happy while your body ached. You gripped your side hard, red spots appearing on your bandage as your incision ruptured slightly - not enough for you to be concerned, but enough for Pablo to rush to your side and comfort you.

"Ay Princesa, don't hurt yourself because I'm stupid."

He got into bed with you, adjusting you so that you were laying against his chest. You felt his heart beat against his chest, the rhythm helping you calm down. He pulled you into him, kissing the top of your head, and playing with your hair.

“I’m so sorry you’re in pain, mi vida.” He muttered quietly, continuing to pet your hair and litter soft kisses on the crown of your head.

You leaned into his touch, enjoying the soft caresses and calm that he brought. You spent the rest of the day in bed, watching movies and going on random tangents. He kept you close, faint touches to remind you he was there no matter what you needed.

“All this love is opening up my appetite, Pablito.”

He looked at you, grinning widely, and jumped off the bed with the excitement of a child to make you something to eat.

~~

Hi injured anon- I hope you feel better soon my love 🫶

Guys I single handedly orchestrated a relationship between my best friend and this cute guy at college. The urge to write a fic about it is UNREAL.

anyways like comment reblog - y’all know the deal. Love you all mwah

[tkingfisher]

Following the monk seals snorting eels post, I’d said that it wouldn’t be the tenth weirdest thing I’d heard about mammals. And then someone in the tags asked what the ten weirdest WOULD be.

Okay, I’ll confess there was some hyperbole there, because I didn’t have ten off the top of my head, but here’s three that strike me as A Thing:

CW: Animal injury and death! Also it’s disgusting! Read at own risk!

We all mostly know about hyena genitals by now, which is pretty wild in and of itself, but it gets weirder. Given that they have to give birth through the pseudo-penis, you’d think they’d be better at it, but the umbilical cord isn’t as long as the lady hyena’s junk, AND there’s a weird elbow turn, so cubs often suffocate on the way out. This may explain why they’re born so goddamn angry that siblings have been observed fighting *while still inside the amniotic sac.*

(I once peed while surrounded by hyenas. The African bush is not an easy place for a woman with a small bladder.)

(That’s not a weird mammal fact, except insomuch as I am a weird mammal.)

Lemurs will take giant millipedes, nip them to make them secrete toxins, then rub the millipede on their fur as insect repellent. But the millipede toxins also make them High As Fuck and cause them to salivate, so you end up with a bunch of stoned, drooling lemurs passing around a millipede that probably had other stuff to do today, dammit.

Ambergris is a weird waxy mass that stinks like the devil eating sardines in hell, and so of course is used in perfume. (It mellows.) For centuries nobody actually knew where it came from, just that it would sometimes wash up on shore. Eventually it was discovered in the guts of sperm whales and some clever soul figured out that it involved the indigestible bits of squid, like beaks. “Aha!” said humanity, “it must be whale vomit!”

Humanity, alas, was unduly optimistic. See, the whales regurgitate most of the squid beaks normally—they’ve got four stomachs, like a ruminant, and since they can’t chew, the first stomach is super tough and muscular to crush their food and to resist the assault of the squid, which is often still alive at this point—and so if they barfed up the beaks, there would be no ambergris. But sometimes they swallow the beaks instead and it lodges in the softer bits of the whale intestines. And then more beaks get hung up on it and more and basically it’s like a whale bezoar, and since this is of course moderately painful, the body secrete a mucusy goo to cover the sharp edges so it doesn’t poke the soft bits, the way an oyster coats sand to make a pearl.

Except, of course, it’s a whale intestine, not an oyster, and instead of a grain of sand, it’s like the world’s most disgusting Katamari. (Okay, technically it’s called a coprolith, aka “shit rock” but it’s just sitting there hooking any indigestible bits that get hung up on it, as well as a bunch of whale poop, and getting bigger and bigger, so I stand by my simile, dammit.)

Now, if you get a whale who keeps swallowing their beaks, over time, the coprolith gets so big that it creates an intestinal blockage. And at that point, one of two things happens. Either the sheer force of liquid whale poo trying to come out dislodges the coprolith and the whale takes the sort of crap that songs are written about…

…or the whale’s gut explodes. (Well, ruptures.) And the whale expires, bloats, pops, goes through the process of whale fall (which is amazing in and of itself) and the ambergris floats to the surface and marinates in seawater for a decade or so, casts up on a beach, and gets sold for a whopping $10k a pound.

Interestingly enough, making ambergris is a very rare condition, found in less than 5% of male sperm whales. (It only happens in males. Don’t ask me why.) Hunting sperm whales for ambergris would be ludicrously inefficient, and it’s classed as a “found” object under international treaties, which means that you can sell it if you find it cast up on a beach, unless you’re in the US, which classes it as a by-product of an endangered species, although enforcement is usually a little more concerned with the people smuggling live parrots in their socks and not with your disgusting lump of found whale poop.

So, yeah. Mammals. We’re a thing.

[kingcunny]

if i wanna be real anal about it im not sure how well any of the asoiaf tv adaptation dragons should be able to fly. its something thats bothered me since got.

they seem to be missing half their wings. in birds those are the secondary flight feathers and are responsible for lift and maintaining flight. i clicked on the ‘bat flight’ wikipedia page and was met with a bunch of math equations and got scared so im not exactly sure how bats do it. but i do understand basic aerodynamics, and i can guess that the arm section of the wing membrane is used to catch wind, similar to birds secondary flight feathers. tv asoiaf dragons are missing this ‘arm’ section of their wings.

but im willing to hand wave it as- theyre magical beings they fly with magic. or if i wanna get xenobiology maybe they have flight bladders like fish have swim bladders.

im getting off my orginal topic here but im actually really into the idea of flight bladders. organs filled with lighter than air gas that helps dragons maintain lift and altitude.

has it been confirmed how dragons breathe fire? im assuming they have some kind of organ filled with either a gas or liquid that ignites when it touches air… that explains meleys exploding when she hit the ground. sudden bodily trauma causing both those organs to rupture, those substances mixing to… explosive results

[a-dauntless-daffodil]

give me dragon rider stories written by horse girls

Give me dragons with differences like horses / mules / donkeys have

don’t care if one spits more fire than the other, tell me there’s dragons who’ve been working with humans for THOUSANDS of years and we’ve specifically been choosing the ones who’ll go along with social pressure even or especially when they’re scared- so when the rider’s their biggest social pressure in their life, they’ll fly into a thunderstorm if their rider tells them to- plenty of fear but no questions- they’ll be scared shitless and have no idea what’s going on or why but if their flock leader said this is where we gotta go then into the storm they go, relying on the rider for every change in pitch and yaw and heading but they’ll DO IT even if it KILLS THEM

(and it’s so easy to kill them in so many small ways, the wrong diet, too much exercise at the wrong time, not kept warm enough- a dragon bred for fire breathing and they have a huge fire bladder that can get twisted inside them if they do too many arial acrobatics on an empty stomach and if the twisting ruptures the bladder then it’s a slow and painful death)  

then there’s the dragons hatched from wild eggs or caught and trained while young, and they almost never have actual riders because of the danger those riders would be in but they can be flown anyway by people on other dragons or even from the ground, they know how to take care of themselves and their flock- they don’t care or understand if the flock is other tamed dragons, or ridden ones, or even humans and animals like horses and dogs- they’ll protect and play with them either way, they’ll actively face danger and die fighting for their flock with a ferocity that’s terrifying- a wild dragon tries picking up one of THEIR horses as a snack and gets one of it’s horns ripped off in the following fight while the horse runs safely away

(but they’ll hunt anything that isn’t their flock which means OTHER horses and other PEOPLE aren’t safe around them- unless they’re kept very well fed and no urge to go hunting their own food ever comes up)

and the dragons in between, the ones hatched from eggs that had one wild parent, the ones who are healthier and stronger than either parent, more hardy than refined but more refined than wild, and they respect a social bond but the self preservations instinct is stronger and riding them isn’t about telling them what do to it’s about ASKING and then WAITING while they consider the situation- if a thunderstorm scares them they won’t fly it, if you try to force them then they’ll chew off their harness and drop you from five hundred feet- better YOU than THEM- but…… if they think it’s doable… if you started them with strong winds and worked up to wind storms, to small squalls, worked with them to learn HOW to ride in increasingly bad weather, made them feel safe and confident around thunder and lighting with you on their back as extra ballast and counterweight, if they can look at the storm and go ah yes we’ve done stuff like this before- THEN they won’t just go into the storm for you they will FLY it themselves they will KNOW how to handle the winds and the updrafts and downdrafts and the poor visibility and even if you have no idea what’s happening or can’t focus on it for some reason they will get you BOTH through it safely, because they wouldn’t have gone into it in the first place otherwise

(hunting isn’t something they jump at but they’ll do it in a pinch and while they won’t win any races or fire breathing contests they also won’t keel over and die from getting the wrong amount of food and rest- they’ll rest when they’re tired and eat until they’re satisfied and you’ll never get 110% or even a 100% of effort out of them since they are always saving some of their reserves for themselves- but they also will probably be with you the longest, staying spry and healthy through generations of human riders, and not burning themselves out until LONG into old age)

give me dragons like horses and mules and donkeys and riders who don't have a get out of free card when climbing on top a creature that could kill them just by rolling over for a back scratch

give me dragon riders with no telepathic bond, no way to communicate directly with their dragon through any shared language

and who love their dragons so much they find a way anyway

give me riders who look after dragons even when the dragons don't beam emotions direct into their heads or talk and act like a large scaly person who for some reason is fine being a permanent taxi service

give me dragons and riders WORKING TOGETHER through so many mundane barriers! that thrill when a giant flying lizard creature comes over when you call them and nuzzles you just because you are theirs-

or the dragon who plays keep away when you're trying to put the flying tack on them, gleefully enjoying a game of chase while you swear internally but also smile- the dragon who stands steady and calm as you show another new rider where all the straps should go so your saddle doesn't catch in the dragon's joints wrong, a dragon who is fine with you moving limbs and wings around as you explain how to secure things so they catch under the dragon's belly just right....

the trust of a dragon who could and would kill you with one snap of it's jaws the moment it didn't trust you anymore

that magic of two creatures who maybe shouldn't ever have ended up partnered like this, but are both happy that they did anyway

GIVE ME HORSE GIRL DRAGON RIDERS

[nico-di-genova]

Drivers are told…to piss themselves if they need to go…because if they hold it…and they hit the wall…their bladder can rupture…

[ronnie-ratke]

Came on here to vent because I’m about to go end it all. It’s gonna be long one if you can read please do

Life has recently been one horrible monstrosity after another. I have three bottle baby lambs I’ve been taking care of around the clock for two months and they have been my biggest reason for living. They need me and I need them. No one else in my family can care for them and I live alone anyway so I’m the only one here 24/7 to care for them. Well one of them had been at the top livestock hospital for 28 days fighting off sepsis in his bones after an umbilical infection. He has just finally come home 12 days ago after being on the edge of life for so long. Then my blind lamb that I have formed an irreplaceable connection with went in for emergency bladder stone surgery, he had a bad blockage and hours left to live if he didn’t get the surgery. He has defied all odds for two months straight being born completely blind with only one physical eye which as I said is blind. I spent about 20 hours a day working with him to help him learn to how survive, get around and eat. Yesterday we got really good news that he was able to pass urine again and he was well on his way to coming home next week. Well this morning they called and said it looks like his urethra ruptured when they were doing the second test to make sure he could pass urine. This is a terminal injury if it’s not right on the tip of it. They are doing an x ray ASAP today to see where it is but there’s like a 95% chance he’s going to have to be put down.

He might “just be a lamb” but to me he was no different than a dog. He was my whole reason for living. I don’t know what to do anymore. I’m completely alone and I’m just done. I’m done with everything. I can’t keep pushing through when life obviously doesn’t want me to. I’m done trying and hoping that “things get better” because they don’t. Nothing gets better. I’ve known this since I was 12 years old but I’m over it now. I texted my boyfriend who’s still asleep that I love him and I’m sorry and my mom and I spoke on the phone. All that I’m waiting on is the final call on the results of the x ray. After that I’ll know what I’m going to do.

Pictures of my baby because he deserves to be seen.

[materialisnt]

its incredible how you can spend 6 hours in constant excruciating agony waiting for a 5 minute procedure that immediately resolves everyone only to come home in ur body and realize ur a stranger there. again.

less than ten minutes after they completed our cath change we filled a 2.5 liter bag with urine, then once it was emptied filled it again in another 20. what the fuck. that shouldnt be enough to fit in the bladder. where was it? how are we alive? how did our bladder not rupture?

they labelled us noncompliant in the ambulance because we told them switching to a cpap would suppress our breathing and if we moved the way they asked we would be in too much pain to be lucid. they turned off sirens because of this and we had to wait almost two hours in a hospital parking waiting for a room lot while our bladder tried to push itself out of our body.

also, this is less than 2 days after finding out our infusion nurse gave us covid. he entered the hone with his mask under his chin and we didnt notice till he had already been calling around for us who knows how long. bitch our chart says we cant hear you! we texted you same day saying to tell us when you were there! we dont know how long we were mutually unmasked but its covid so. long fucking enough

honestly the fucked up collagen is probably the only reason our bladder didnt burst. i dont know whether to be grateful or not so im gonna eat a popsicle, drink some juice, and try to figure out who the fuck i am after all of that.

[daskibum]

Groot almost died: the story of one of the most expensive dogs alive (probably an exaggeration)

I kept thinking his slowdown was age. Turns out, it was an infection. Long story:

He broke his foot in Sept. After 6 weeks and antibiotics he was finally out of bandages but had little blisters running up his leg. Everyone thought it was clogged pores or maybe infected hair follicles. Just looked like blisters a person would get from an ill fitting shoe. Shortly after his one foot healed he had a cyst rupture out of his pad on the other foot. 6 weeks in bandages and antibiotics for that foot. He finally got out of everything for a few weeks. During the 4 foot snowstorm he seemed really off. Just mopey. I figured he was mad about 4 feet of snow so was stuck inside. Finally got him out for a walk Tuesday. Half way through his walk blood ruptured out of his leg. Took him home, shaved it, cleaned it, sent pics to vet. We decide it didn’t look bad, he would be fine till the next day. By 4 pm it has oozed all day and he can barely stand. Rushed him 1.5 hours north to one of the best vet hospitals in the country and one of the only places in the state they can handle a dog his size. He was in shock when I got there. They eventually find 3 more cysts in his leg. The blisters were little ant trails running from these deep cysts out. It is a strep infection. Its in his leg, bladder, and spine. His mobility slowdowns have most likely been from this. So 4 days in the hospital and 15k dollars… he is home. This puts him at around $35k in 6.5 years.

Hes worth it.

[the-owl-tree]

istg deer you have the funniest mutuals on planet earth... "sorry I keep taking them all I just can't stop giving birth" is making me cackle so hard I genuinely think I might rupture my bladder LMAOOOOOOOOOOO

you can thank @gayleafpool for that one that made me howl LMAO

funny enough i was like aw man is this a weird post but thankfully everyone in the tags said watch this

[spotsupstuff]

Can you give us some more specifics on how iterator puppets’ biological organs work?

uhhhhhhh 1 is a pumpy pumpy like heart, its job is to make water circulate through the puppet in order to cool it down (they got veins n shit i'm just -lies down on the floor- bout these kind of things)

pumpy pumpy is monitored by a pressure gauge specifically in Gen 1 iterators because of the shifting gravity within the chamber. we wouldn't wanna the organs to rupture cuz of a singular brain blast (which i imagine is a high gravitational pressure applied to a singular point. in-game Pebbles basically squishes/implodes the slugcat's brain)

number 2 are kinda like??? my main idea was a place where the water could sit for a bit, especially the nasty one, before it's extracted by the tube in the umbilical arm. so TECHNICALLY bladder, but then i added the idea that one of those organs filters the water to separate really bad gunk from the softer gunk. so basically a combo of the kidneys and the end of human digestive system

i ain't a biology nerd so like

[whumpy-daydreams]

Types of surgery

Masterlist

So... you want to know about surgery. Well buckle in folks because this is just the first in an eleven part series. Enough of the humour though let's get medical. I've split this into 'categories', or how soon do you need this; and 'specialties', or what needs fixing

Categories of surgery

Elective - this is planned ahead of time, and isn't very time sensitive. also the majority of surgeries

Expedited - not life threatening but should be done asap. Includes tendon and nerve injures, some minor bone fixes, some stents and eye stuff

Urgent - needs to be done within a few hours to prevent loss of function/life. Fixing badly broken bones, perforated bowels, eye injuries, D&C (dilation and curetting)

Emergency - needs to be done immediately with threat to life or organs/limbs. Haemorrhage (loads of bleeding internally or externally), burst appendix, ruptured cancers, emergency c-sections

This is not a complete list of surgeries, and amputation can be any of these categories

There may also be extra categories at different hospitals that specify actual times. Emergency c-sections have time limits, with the most urgent needing to be started within an hour.

Surgical Specialties

Breast - pretty obvious, it's boob surgery and it's harder than you think (part of general surgery)

Cardiothoracic - treats the heart, lungs and airway, usually long surgeries with lots of equipment

Ear, nose, throat (ENT) - think tonsils, think deviated septum. I hate it. It smells bad.

Endocrine - if it's got gland in the name you're good. Think thyroid, pancreas, adrenal etc. (part of general surgery)

Gastrointestinal - deals with the stomach, intestines, colon, and rectum (part of general surgery)

Gynecology and obstetrics - treats the uterus and related reproductive organs (no penises here sorry). It can smell a little bad but not as bad as ENT

Neurosurgery - zombies love it but they got their medical licence revoked. Yep it's brain time baby (and the spinal cord but who cares about that). Known for being difficult and long

Oral and maxillofacial (maxfax) - mouth and face (not to be confused with plastic surgery, though they get involved), bones, teeth and soft tissue of the face as long as it's not ear, nose or throat.

Other general stuff - kidneys, liver, pancreas, gallbladder and random things in the abdomen

Plastic - reconstructing things. It's not always cosmetic, they make a big difference to trauma patients and also do cleft palate. Absolute perfectionists so prepare to be there for ages

Trauma and orthopaedic - bones and joints like fixing broken bones, carpal tunnels, and joint replacements. This is my favourite speciality because I think the surgeons are funnier and I like hammers

Urology - all the penises! And testicles and related reproductive system. Usually amab patients but they do treat afab patients too - everyone has a bladder

Vascular - blood tubes and lymphatic system (don't ask me to explain it please I beg you), can be really long surgeries and is usually done under a microscope

And I'm done (for now)