Spontaneous rupture of neurogenic bladder

Pneumoperitoneum is abnormal presence of air or any other gas in the peritoneal cavity. This finding can be both benign or a sign of a grave underlying pathology and a wide spectrum of clinical conditions can attribute to the finding. Prompt clinical examination of a case of abdominal pain can identify findings of peritonitis. We are reporting an interesting case report about a patient of acute abdomen with pneumoperitoneum and peritonitis which was caused by spontaneous rupture of urinary bladder. A 36-year-old male, came with complaints of abdominal pain for one day, two episodes of non-bilious vomiting. He was a known case of neurogenic bladder on continuous bladder drainage. Systemic examination of the abdomen showed warmth, diffuse tenderness, guarding and absent bowel sounds. Bladder catheterisation showed clear urine. On investigation, He had pneumoperitoneum in chest X-ray and free fluid in ultrasonography. A clinical diagnosis of hollow viscus perforation was made and emergency laparotomy was done in view of signs of peritonitis. There was rupture of the dome of urinary bladder with necrosis of the bladder wall and extravasation of urine into the peritoneal cavity. This rare presentation should remind us to keep all the differential diagnoses in mind while opening a case of perforation peritonitis as timely intervention can well and truly be the difference between life and death.

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Spontaneous Rupture of Urinary Bladder (SRUB) in a Young Male, Presenting as Anuria – A Case Report and Review of Literature

The Open Urology & Nephrology Journal ◽

10.2174/1874303x01407010064 ◽

2014 ◽

Vol 7 (1) ◽

pp. 64-66

Author(s):

Sekar Hariharasudhan ◽

Sriram Krishnamoorthy ◽

Sunil Shroff

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Urinary Bladder ◽

Spontaneous Rupture ◽

Lower Abdominal Pain ◽

Young Male ◽

Bladder Rupture ◽

Emergency Laparotomy ◽

High Morbidity ◽

Delay In Diagnosis

Spontaneous rupture of urinary bladder is a rare condition. Most of the bladder ruptures occur in association with blunt or penetrating injuries to the lower abdomen. Most often, a vague lower abdominal pain is the mode of presentation. Rarely patients present with oliguria, anuria, uremia or urosepsis. A forty year old male, under the influence of alcohol, presented with lower abdominal pain and anuria for two days with abnormal renal function. He denied history of blunt trauma. He was diagnosed to have an intra-peritoneal rupture of urinary bladder. He underwent emergency laparotomy with repair of bladder rupture. This case report illustrates the need for a high index of clinical suspicion. Prompt diagnosis and appropriate management will help in preventing a poor clinical outcome in patients with spontaneous bladder perforation. If left untreated or if there is a considerable delay in diagnosis and intervention, it usually is associated with a high morbidity.

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Spontaneous Rupture of Urinary Bladder: Two Case Reports and Review of Literature

Frontiers in Surgery ◽

10.3389/fsurg.2021.721705 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yue Zhang ◽

Shuo Yuan ◽

Rami W. A. Alshayyah ◽

Wankai Liu ◽

Yang Yu ◽

...

Keyword(s):

Abdominal Pain ◽

Urinary Bladder ◽

Antibiotic Therapy ◽

Acute Abdomen ◽

Spontaneous Rupture ◽

Bladder Tumor ◽

Bladder Rupture ◽

Intraperitoneal Rupture ◽

History Of ◽

Ct Cystography

Objectives: Spontaneous rupture of the urinary bladder (SRUB) is extremely rare and might be misdiagnosed, leading to a high mortality rate. The current study aimed to identify the cause, clinical features, and diagnosis strategy of SRUB.Methodology: We presented a case report for two women (79 and 63 years old) misdiagnosed with acute abdomen and acute kidney injury, respectively, who were finally confirmed to have SRUB by a series of investigations and exploratory surgery. Meanwhile, literature from multiple databases was reviewed. PubMed, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Biological Medical Literature Database (CBM), WANFANG DATA, and the Chongqing VIP database for Chinese Technical Periodicals (VIP) were searched with the keywords “spontaneous bladder rupture” or “spontaneous rupture of bladder” or “spontaneous rupture of urinary bladder.” All statistical analyses were conducted using SPSS 20.0 software.Results: A total of 137 Chinese and 182 English literature papers were included in this article review. A total of 713 SRUB patients were analyzed, including the two patients reported by us. The most common cause of SRUB was alcohol intoxication, lower urinary tract obstruction, bladder tumor or inflammation, pregnancy-related causes, bladder dysfunction, pelvic radiotherapy, and history of bladder surgery or bladder diverticulum. Most cases were diagnosed by exploratory laparotomy and CT cystography. Patients with extraperitoneal rupture could present with abdominal pain, abdominal distention, dysuria, oliguria or anuria, and fever. While the main symptoms of intraperitoneal rupture patients could be various and non-specific. The common misdiagnoses include acute abdomen, inflammatory digestive disease, bladder tumor or inflammation, and renal failure. Most of the patients (84.57%) were treated by open surgical repair, and most of them were intraperitoneal rupture patients. Overall, 1.12% of patients were treated by laparoscopic surgery, and all of them were intraperitoneal rupture patients. Besides, 17 intraperitoneal rupture patients and 6 extraperitoneal rupture patients were treated by indwelling catheterization and antibiotic therapy. Nine patients died of delayed diagnosis and treatment.Conclusions: SRUB often presents with various and non-specific symptoms, which results in misdiagnosis or delayed treatment. Medical staff noticing abdominal pain suggestive of peritonitis with urinary symptoms should be suspicious of bladder rupture, especially in patients with a history of bladder disease. CT cystography can be the best preoperative non-invasive examination tool for both diagnosis and evaluation. Conservative management in the form of urine drainage and antibiotic therapy can be used in patients without severe infection, bleeding, or major injury. Otherwise, surgical treatment is recommended. Early diagnosis and management of SRUB are crucial for an uneventful recovery.

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Successful treatment for intra-abdominal bleeding due to spontaneous rupture of huge liver cyst using transcatheter arterial embolization: a case report

International Journal of Case Reports ◽

10.28933/ijcr-2021-09-0105 ◽

2021 ◽

pp. 242

Author(s):

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Ct Scan ◽

Spontaneous Rupture ◽

Lower Abdominal Pain ◽

Arterial Embolization ◽

Liver Cyst ◽

Rare Presentation ◽

Liver Cysts ◽

Abdominal Bleeding

Background: Non-parasitic simple liver cysts are one of the most common benign hepatic lesions. Although most liver cysts are asymptomatic and remain silent throughout the patient’s life, extremely large cysts can become symptomatic by direct compression to adjacent organs. Herein, we report a case of a spontaneously ruptured simple liver cyst, which is a rare presentation of a benign liver cyst. The patient’s liver cyst re-ruptured and was treated with transcatheter arterial embolization (TAE). Case report: A 62-year-old man presented to our hospital complaining of acute-onset lower abdominal pain. He had undergone laparoscopic fenestration of a huge liver cyst in another hospital 2 years prior. Computed tomography (CT) scan showed spontaneous rupture of a large liver cyst. Laparoscopic exploratory laparotomy showed no signs of ongoing intra-abdominal bleeding from the liver cyst; therefore, the operation was completed with peritoneal lavage. The patient was discharged from our hospital on postoperative day 5. Twelve days after the initial presentation, the patient was re-admitted to our hospital complaining of recurrence of lower abdominal pain. CT scan showed an enlargement of the previously ruptured liver cyst, with intra-abdominal bleeding and massive hematoma in the cyst. Extravasation of the cyst’s wall was also detected. Under the diagnosis of intra-abdominal bleeding from the artery in the wall of the huge cyst, emergent TAE was performed. Although the exact spot of extravasation was not detected, the anterior segment branch of the right hepatic artery, which corresponds to extravasation shown on the CT scan, was embolized. The patient was discharged from our hospital after 7 days, and the liver cyst remained stable without abdominal pain for more than 2 months. Conclusions: This case highlights a rare presentation of spontaneous rupture of a liver cyst with massive bleeding and the efficacy of TAE for the conservative treatment of ruptured liver cysts.

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Atraumatic Splenic Rupture is a Rare Complication of Acute Myeloid Leukemia: A Case Report and Literature Review

10.32592/ircmj.2021.23.12.1469 ◽

2021 ◽

Keyword(s):

Abdominal Pain ◽

Splenic Rupture ◽

Rare Complication ◽

Bone Marrow Aspiration ◽

Underlying Disease ◽

Free Fluid ◽

Histopathological Study ◽

Emergency Laparotomy ◽

Limited Information ◽

Atraumatic Splenic Rupture

Introduction: Atraumatic Splenic Rupture (ASR) is a rare but life-threatening clinicopathological phenomenon with limited information on patient features, occurrence, or etiology. Case presentation: A 48-year-old man with no history of the underlying disease presented to the emergency department with abdominal pain. He was admitted with leukocytosis 145x103/µl, hemoglobin 6.4 g/dl, and platelets 15x103/µl, ESR 89mm/h, D-Dimer 1043ng/FEU ml. Sputum test (PCR) ruled out SARS-CoV-2 infection. Due to peripheral blood smear and bone marrow aspiration/biopsy, AML was diagnosed for the patient. On the third day of hospitalization, the patient's abdominal pain intensifies. Ultrasound revealed medium free fluid inside the abdomen and pelvis. The patient was transferred to the operating room to undergo an emergency laparotomy. There was a large hematoma in the spleen with a rupture in its posterior surface. Splenectomy was performed. The histopathological study of the spleen showed leukemic involvement, capsular ruptures, and subcapsular hematomas. Discussion: ASR is an uncommon and lethal complication that is seen in infectious diseases (mainly mononucleosis) and hematological diseases (mainly malignant homeopathies) in more than half of cases. Mortality is approximately around 20%. Some deaths occur before the diagnosis is confirmed, while others occur after surgery, as a result of delayed management and poor patient status. Conclusion: ASR can occur for a variety of reasons, including non-traumatic or idiopathic factors. In the absence of significant trauma, emergency physicians should be aware that splenic rupture can occur. ASR is more likely to present with symptoms similar to the underlying disease.

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An Unusual Iatrogenic Injury of Urinary Bladder Following Foley’s Catheterization

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd9-4/017 ◽

2020 ◽

Keyword(s):

Abdominal Pain ◽

Urinary Bladder ◽

Bladder Wall ◽

Signs And Symptoms ◽

Pelvic Trauma ◽

Iatrogenic Injury ◽

Bladder Rupture ◽

Bladder Diverticulum ◽

Urethral Trauma ◽

Prostatic Enlargement

Urinary bladder perforation is most commonly observed after pelvic trauma. It can also be a result of iatrogenic injury during various surgical procedures. Very rarely, diseased bladder can spontaneously rupture. Traumatic bladder rupture is a serious event with mortality rate approaching 50%. Urinary bladder diverticulae are present of the bladder wall and are a consequence of bladder outﬂow obstruction, for example in prostatic enlargement. Foley’s catheterization is most commonly associated commonly with urethral trauma. We presented a emphasis is made unique case of perforation of urinary bladder diverticulum after Foley’s catheterization. To the best of our knowledge, such a case has never been reported before in the medical literature. An emphasis was made on the fact that, physicians should keep in mind the differential of perforated urinary bladder while attending a patient with abdominal pain because the signs and symptoms are very non specificurinary bladder while attending a patient with abdominal pain just because its signs and symptoms are very non-speciﬁc. In addition, missing a perforated urinary bladder is easy and can result in signiﬁcant morbidity and mortality. Keywords: Bladder Diverticulum; Urinary Catheters; Perforation.

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A rare case of acute abdomen: spontaneous rupture of degenerated fibroid

BMJ Case Reports ◽

10.1136/bcr-2020-238010 ◽

2021 ◽

Vol 14 (3) ◽

pp. e238010

Author(s):

Nidhi Goswami ◽

Aderemi Alalade

Keyword(s):

Ct Scan ◽

Acute Abdomen ◽

Spontaneous Rupture ◽

Rare Case ◽

Surgical Intervention ◽

Elective Surgery ◽

Fluid Collection ◽

Emergency Laparotomy ◽

Rare Presentation ◽

Large Uterus

A 29-year-old nulliparous woman presented with an acute abdomen. She had a large uterus with multiple fibroids and was on the waiting list for elective surgery. An urgent CT scan demonstrated an extensive intraperitoneal fluid collection suspicious for fibroid rupture. She required an emergency laparotomy which identified a rupture of the largest degenerative fibroid. There was 2 Litres of pus in the peritoneal cavity. This case was a rare presentation of spontaneous fibroid rupture due to degeneration and necrosis, and acute abdomen from peritoneal irritation. Imaging was vital in making the diagnosis, and urgent surgical intervention was essential to reduce morbidity and mortality.

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Spontaneous Splenic Rupture in Melanoma

Case Reports in Pathology ◽

10.1155/2014/865453 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Hadi Mirfazaelian ◽

Ahmad Oryan ◽

Aida Davari ◽

Khosrow Daneshbod ◽

Yahya Daneshbod

Keyword(s):

Abdominal Pain ◽

Malignant Melanoma ◽

Spontaneous Rupture ◽

Splenic Rupture ◽

Acute Abdominal Pain ◽

Past History ◽

Case Reports ◽

Metastatic Malignant Melanoma ◽

Free Fluid ◽

Diffuse Infiltration

Spontaneous rupture of spleen due to malignant melanoma is a rare situation, with only a few case reports in the literature. This study reports a previously healthy, 30-year-old man who came with chief complaint of acute abdominal pain to emergency room. On physical examination, abdominal tenderness and guarding were detected to be coincident with hypotension. Ultrasonography revealed mild splenomegaly with moderate free fluid in abdominopelvic cavity. Considering acute abdominal pain and hemodynamic instability, he underwent splenectomy with splenic rupture as the source of bleeding. Histologic examination showed diffuse infiltration by tumor. Immunohistochemical study (positive for S100, HMB45, and vimentin and negative for CK, CD10, CK20, CK7, CD30, LCA, EMA, and chromogranin) confirmed metastatic malignant melanoma. On further questioning, there was a past history of a nasal dark skin lesion which was removed two years ago with no pathologic examination. Spontaneous (nontraumatic) rupture of spleen is an uncommon situation and it happens very rarely due to neoplastic metastasis. Metastasis of malignant melanoma is one of the rare causes of the spontaneous rupture of spleen.

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Spontaneous Rupture of Pyometra in a Nonpregnant Young Woman

Case Reports in Obstetrics and Gynecology ◽

10.1155/2017/4572379 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Parvin Mostafa-Gharabaghi ◽

Shima Bordbar ◽

Shabnam Vazifekhah ◽

Mohammad Naghavi-Behzad

Keyword(s):

Abdominal Pain ◽

Blood Transfusion ◽

Young Woman ◽

Spontaneous Rupture ◽

Vaginal Bleeding ◽

Hemodynamic Instability ◽

Free Fluid ◽

Full Thickness ◽

Abdominal Sonography ◽

Previous Cesarean

A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing. There was not any myomectomy scar.

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Hysterectomy with Fetus In Situ for Uterine Rupture at 21-Week Gestation due to a Morbidly Adherent Placenta

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/5430591 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Katerina Pizzuto ◽

Cory Ozimok ◽

Radenka Bozanovic ◽

Kathleen Tafler ◽

Sarah Scattolon ◽

...

Keyword(s):

Abdominal Pain ◽

Uterine Rupture ◽

Early Recognition ◽

Small Body ◽

Bladder Wall ◽

Exploratory Laparotomy ◽

Pregnant Patient ◽

Free Fluid ◽

Morbidly Adherent Placenta ◽

Adherent Placenta

Background. Uterine rupture due to a morbidly adherent placenta is a rare obstetrical cause of acute abdominal pain in the pregnant patient. We present a case to add to the small body of published literature describing this diagnosis. Case. A 32-year-old G5T2P1A1L2 with multiple prior cesarean sections presented at 21+3 weeks’ gestation with abdominal pain and presyncope. Ultrasound showed a large volume of complex intraabdominal free fluid and a heterogenous placenta with irregular lacunae and increased vascularity extending to the posterior bladder wall. Exploratory laparotomy identified a uterine defect and a hysterectomy was performed due to significant bleeding. Pathology confirmed a diagnosis of placenta percreta. Conclusion. Early recognition and management of uterine rupture due to a morbidly adherent placenta are essential to prevent catastrophic hemorrhage.

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