Pneumoperitoneum Caused by Gangrenous Cystitis: An Unusual Presentation

Pneumoperitoneum is most often associated with gastrointestinal perforation, but rare extra-digestive causes exist. Gangrenous cystitis is a severe and uncommon bladder infection that can exceptionally lead to pneumoperitoneum.We report a case of pneumoperitoneum secondary to gangrenous cystitis in a 31-year-old patient initially hospitalized for dorso-lumbar trauma. The postoperative course was complicated by a severe urinary tract infection. One month later, abdominal computed tomography revealed pneumoperitoneum with a thickened, heterogeneous bladder wall suggestive of gangrenous cystitis. Emergency surgical exploration showed a necrotic, gangrenous bladder without any gastrointestinal perforation.Gangrenous cystitis can rarely present with pneumoperitoneum and mimic gastrointestinal perforation. Early recognition and prompt surgical management are crucial for patient recovery.