Spontaneous Rupture of Urinary Bladder with Vesicocutaneous Fistula in a HIV Positive Female: Case Report

Abstract

Spontaneous rupture of urinary bladder is a rare presentation with high morbidity and mortality. Symptoms resemble acute peritonitis in most cases. Rarely, urine circumvents via vesicocutaneous fistula. A 60-year-old bed ridden female, seropositive for Human Immunodeficiency Virus (HIV), presented to the emergency department with complaints of suprapubic ulcer and urine leak from the ulcer site for 15 days. On clinical examination, there was Spontaneous Rupture of Bladder (SRUB) secondary to chronic retention of urine was found. Computed Tomography (CT) cystogram revealed vesicocutaneous fistula. She was managed using foley’s catheter insertion. Percutaneous Nephrostomy (PCN) insertion failed due to technical reasons. She soon succumbed due to Acute Kidney Injury (AKI), respiratory acidosis. This case is studied because of its rarity and importance of early diagnosis and management. Till date, no case of SRUB depicting clinical presentation in HIV patient has been reported.

Keywords

• bladder rupture
• cystogram
• immunocompromised
• percutaneous nephrostomy