Spontaneous Intraperitoneal Bladder Rupture: A Rare Case Report

Abstract

Spontaneous Rupture of Urinary Bladder (SRUB) is an extremely atypical case (reported incidence of 1:126000) presenting to the emergency as an acute abdomen with other non-specific symptoms leading to high rates of misdiagnosis and mortality. A connection to urinary obstruction or bladder wall weakness is often elicited in retrospect. A case of a 70-year-old male with spontaneous bladder rupture secondary to a previously undiagnosed bladder growth was presented. He presented to us with gradual abdominal distension, vomiting and biochemical parameters suggestive of acute renal failure. Ultrasonography of the abdomen revealed loculated intraperitoneal collection and bladder wall thickening with growth on the anterior and posterior walls of the urinary bladder. Exploratory laparotomy revealed uroperitoneum resulting from a bladder growth that had fungated through the posterosuperior aspect of the urinary bladder. Primary repair was done and catheter was retained to provide adequate urinary evacuation per urethra. Postoperatively patient made a slow recovery complicated by occasional episodes of dyselectrolytemia and respiratory infection which could be successfully managed. He was discharged two weeks later with indwelling catheter to the departments of urosurgery and oncology with a histopathological diagnosis of Squamous Cell Carcinoma (SCC).

Keywords

• acute abdomen
• bladder carcinoma
• peritonitis
• squamous cell carcinoma
• uroperitoneum