Isolated intraperitoneal urinary bladder rupture secondary to blunt abdominal trauma encountered during a road traffic accident: a case report.

Abstract

Introduction and importance: In general, bladder injuries are rare, particularly in the case of intraperitoneal bladder rupture secondary to blunt abdominal trauma. The diagnosis of intraperitoneal bladder rupture in rural places is difficult and is made at a late stage associated with complications leading to poor outcomes.

Case presentation: We present the case of a 35-year old married black African man who had an isolated intraperitoneal bladder injury secondary to blunt abdominal trauma with an intact pelvis that occurred due to a road traffic accident. The clinical picture and the investigations done led to a laparotomy that revealed a bladder dome tear, which was repaired in two layers.

Clinical discussion: The anatomical position of the urinary bladder in adults protects it from injuries because the pelvic bone surrounds it. The current guidelines recommend a surgical treatment for intraperitoneal bladder rupture. Computed tomography, with its ability to diagnose concomitant injuries, with retrograde cystography is the investigation of choice; however, deterioration of the patient's clinical picture or presence of signs and symptoms of peritonitis should lead to emergency laparotomy prior to further investigations. On-time diagnosis and accurate treatment constitute a pillar for the best outcome for the patient.

Conclusion: There should be a high index of suspicion of intraperitoneal bladder rupture in a patient following blunt abdominal trauma, and the clinician should be alerted about it in case of deterioration or presence of signs and symptoms dictating laparotomy. The patient had an uneventful recovery.