Spontaneous Rupture of Urinary Bladder: A Case Report

Background Spontaneous rupture of urinary bladder (SRUB) is a rare surgical emergency that can be incorrectly diagnosed with ease. While it is more common in those with underlying bladder pathologies, this incidence may occur in patients with previously insignificant medical condition. Prompt diagnosis and surgical intervention are essential to circumvent grave complications. Case Report A 60-year-old man who presented with inability to void, suprapubic pain and swelling. Initial clinical examination revealed a tender suprapubic distension with stable vital signs except for elevated blood pressure (180/104mmHG). Attempts at urethral catheterization by the casualty officer was abortive. However, while still receiving the initial care at the emergency room, the patient felt a burst in his abdomen with progressive generalized distension afterwards. Abdominopelvic ultrasound scan (USS) done showed gross ascites whereas plain abdominal radiographs (erect and supine) was suggestive of intestinal perforation. He underwent emergency laparotomy with identification of the posterior urinary bladder wall perforation which was repaired in two layers. The patient’s post-operative period was uneventful. Tenth day post-surgery, the patient was discharged home with no complications. Conclusion Spontaneous rupture of the urinary bladder is very rare. High index of suspicion alongside a detailed evaluation with prompt surgical intervention could avert possible complications.