Spontaneous, idiopathic urinary bladder perforation – case report

Abstract

Spontaneous, idiopathic urinary bladder rupture is a very rare disease entity, which may face the problem of proper preoperative diagnosis. In many cases the medical history, physical examination, and additional tests raise false suspicion of gastrointestinal perforation. The study presented a case of a female patient with spontaneous urinary bladder perforation, paying particular attention to the diagnostic difficulties associated with the above-mentioned pathology. The aim of the study was to analyse the presence of symptoms and imaging and laboratory results observed in case of spontaneous urinary bladder rupture, as well as differentiate the above-mentioned pathology with gastrointestinal perforation. Whenever diagnosing a patient with acute peritonitis symptoms, in whom the predominating symptoms include sudden abdominal pain, peritoneal cavity fluid presence, hematuria, oliguria, and coexisting increased urea, creatinine, and potassium levels, one should consider the possibility of urinary bladder rupture.

A Case of Idiopathic Recurrent Spontaneous Bladder Rupture

“…Expeditious diagnosis and emergent surgery is essential for good outcomes [ 1 ]. Most spontaneous bladder ruptures are not idiopathic, but are associated with a history of radiation, neurogenic bladder, or intoxication [ 1 – 10 , 17 , 21 ]. Idiopathic spontaneous bladder ruptures are unusual [ 11 – 14 ], and because of this, the diagnosis can be challenging.…”

“…Spontaneous bladder ruptures are usually associated with intoxication, radiation, stricture, cancer, or a neurogenic bladder [ 1 – 10 ]. Rarely, they can be idiopathic [ 11 – 13 ] or recurrent [ 14 – 19 ], and a recurrent idiopathic spontaneous bladder rupture has only been described once [ 20 ].…”

A case of spontaneous urinary bladder rupture secondary to urinary retention due to an urethral stricture

“…Urinary bladder ruptures are commonly associated with blunt abdominal trauma or iatrogenic causes like catheterization. 2 Patients who suffer from spontaneous ruptures usually have one or more risk factors. Literature provides only a few case reports of patients with spontaneous bladder ruptures due to a variety of underlying conditions.…”

“…Initial presentation of bladder ruptures is often unspecific, and may differ from mild voiding complaints with small amounts of ascites, to peritoneal irritation with increased creatinine due to reabsorption. 2 If a rupture exists for an extended period of time (>24 hours), urine tests may show microscopic haematuria. Furthermore, an elevated serum creatinine due to reuptake of urine creatinine through the peritoneum is commonly seen.…”

Spontaneous Intraperitoneal Bladder Rupture, a Report of Two Cas

“…These cases are usually overlooked and should be suspected when the predominating symptoms include acute peritonitis, sudden abdominal pain, peritoneal cavity fluid, oliguria, hematuria with increased serum creatinine, BUN and potassium levels [9]. Most of the reported cases occurred in men with infravesical obstruction [1,3,10].…”