Spontaneous rupture of the urinary bladder due to bacterial cystitis

Abstract

We report a case of spontaneous rupture of the urinary bladder (SRUB) due to bacterial cystitis in a 76-year-old woman with chief complaint of abdominal pain a day before presentation. She had fever (38.0°C), and her systolic blood pressure dropped to 70 mmHg; she was referred to our hospital, where she was admitted with a diagnosis of ileus. However, her abdominal pain worsened the following day, and abdominal CT showed free air. Emergency laparotomy was performed for suspicion of digestive tract perforation, which revealed a small hole at the dome of the urinary bladder and another at the peritoneum. Suture repair was performed. We reviewed the abdominal CT on admission and noted that the perforation of the urinary bladder was present during admission, whereas that of the peritoneum occurred the following day. SRUB is rare, and bacterial cystitis rarely causes it; thus, accurate diagnosis and proper treatment are essential.

Spontaneous Intraperitoneal Rupture of Bladder Diverticulum: A Rare Cause of Peritonitis

“…Urinary bladder ruptures are in most cases secondary to blunt abdominal trauma, pelvic fractures, or iatrogenic causes, and 96.6% of all cases of bladder ruptures are posttraumatic [ 8 , 9 ]. A spontaneous, nontraumatic urinary bladder rupture is a very rare surgical emergency, with an incidence of 1 : 126,000 and a mortality rate of 47% [ 5 ].…”

“…When diagnosed, treatment depends on type of bladder rupture as well as the presence of an underlying pathology which may require additional treatment [ 6 ]. Intraperitoneal rupture of a bladder diverticulum requires immediate surgical repair to avoid serious complications, it can be made by laparotomy or laparoscopically in selected patients [ 3 ], and it consists of exploring the whole abdominal cavity, excising the diverticulum, repairing the bladder defect, and draining the abdominal fluid [ 4 , 8 , 13 , 14 ]. Conservative management without surgery can be successfully used in carefully selected patients with only urinary catheterization and antibiotics, with or without percutaneous peritoneal drainage [ 1 , 4 , 7 ].…”

Spontaneous bladder rupture due to bladder carcinoma: A case report required emergency radical cystectomy

“…Spontaneous bladder rupture is rare and is associated with high morbidity and mortality. 2 , 3 Common causes of spontaneous bladder rupture are pelvic irradiation, retention, chronic cystitis, invasive tumor, and diverticulitis. 1 Typical CT images of bladder rupture into the peritoneal cavity show accumulation of ascites and free air.…”

“…1 Typical CT images of bladder rupture into the peritoneal cavity show accumulation of ascites and free air. 2 Leaked urine causes ileus, peritonitis, and elevation of BUN and creatinine due to reabsorption. 1 However, these findings are also observed in case of intestinal perforation.…”

“…1 However, as its clinical findings are similar to those of intestinal perforation, bladder rupture can sometimes be misdiagnosed, even with the aid of computed tomography (CT) imaging. 2 …”