Spontaneous Rupture of the Urinary Bladder: A Case Report

Abstract

Spontaneous rupture of the bladder (SRUB) is a rare occurrence globally (<1%). The most common cause of bladder rupture is trauma (96%). We present a case of a 34-year-old man with a history of heavy alcohol consumption and significant smoking history. He presented with diffuse abdominal pain and urinary retention. On blood tests, he was found to have increased creatinine. A urinary catheter was inserted and there was improvement in his kidney function. However, on removal of the catheter, his creatinine function would elevate. This occurred two times before further investigations were performed. CT cystography was performed and there was a significant amount of free intraperitoneal fluid found in the pelvis. After retrograde filling of the bladder with contrast material, a tear in the dome of the bladder was discovered. The patient underwent a surgical repair of the tear and there were no complications during surgery. In summation, spontaneous urinary bladder rupture is a rare emergency which can cause acute abdomen, oliguria, peritoneal effusion and abnormal renal function. In patients with heavy alcohol consumption and especially without an associated trauma history, physicians should consider SRUB. CT scan can help in diagnosis. Diagnostic laparoscopy or explorative laparotomy should not be delayed.