A Late Presentation of Spontaneous Bladder Rupture During Labor

Abstract

Spontaneous bladder rupture is usually due to bladder diseases. Bladder rupture during labor or postpartum is extremely rare. Acute abdomen is the usual presentation of spontaneous bladder rupture. Patients may complain of suprapubic pain, anuria and hematuria. Some patients with intraperitoneal bladder rupture may have no abdominal pain and can pass urine without any symptoms so the diagnosis of intraperitoneal rupture may be difficult in these situations. We report a nulliparous woman with abdominal pain and distension about 20 days after normal vaginal delivery. There was intraperitoneal rupture of bladder in dome of bladder which was sealed by jejunum.

Spontaneous Intraperitoneal Bladder Rupture, a Report of Two Cas

“…Most of the reported cases occurred in men with infravesical obstruction [1,3,10]. However, few cases of SBR has been reported in females during or shortly after obstructed labor [7,8]. Other predisposing factors include inflammation of the bladder, tumor, stones and surgical scar [3].…”

“…Predisposing causes for spontaneous bladder rupture (SBR) include: inflammation, tumor, tuberculosis, stones, diverticulum or surgical scar [3]. Other predisposing causes are altered sensitivity [4], radiotherapy [5,6] and obstructed labor [7,8]. We present 2 cases of spontaneous bladder rupture, one male and one female.…”

Perforated viscus; not always bowel: case report of spontaneous bladder rupture

“…It usually causes intraperitoneal rupture of the bladder; as the dome is the least supported part of the bladder and the area covered by peritoneum . There are multiple causes including outlet flow obstructions, radiotherapy, malignancy, necrotizing cystitis, alcohol intoxication, obstructed labour and neurogenic bladder . It is an important differential for an acute abdomen, especially when gross ascites is found rather than pneumoperitoneum.…”

“…It is an important differential for an acute abdomen, especially when gross ascites is found rather than pneumoperitoneum. Symptoms can be vague but may include suprapubic pain, haematuria, nausea or vomiting . Serum tests may mimic acute kidney injury with elevation of urea, creatinine, hypokalaemia and azotaemia due to equilibration across the peritoneal membrane of plasma and intra‐abdominal urine .…”

“…Symptoms can be vague but may include suprapubic pain, haematuria, nausea or vomiting . Serum tests may mimic acute kidney injury with elevation of urea, creatinine, hypokalaemia and azotaemia due to equilibration across the peritoneal membrane of plasma and intra‐abdominal urine . Diagnosis, especially with initial imaging, is difficult .…”