Spontaneous rupture of bladder diverticulum: a case report of non-traumatic extraperitoneal urinary bladder rupture managed with surgical intervention

Spontaneous extraperitoneal bladder rupture is a rare urology emergency. Most of the extraperitoneal urinary bladder rupture cases were management conservatively. To my best knowledge, there was very few reported about outcome of surgical management for spontaneous extraperitoneal urinary bladder rupture. Herein we shared our experience treating a 84 year old male who first presented with gross hematuria and frequent clots retention. Later he developed septic shock and peritonism which prompted us to do an urgent CT and found out the cause of his acute abdomen. The dilemma we faced to go in for operation was explained and patient had a turbulent post-operative time and he eventually succumbed to death due to various factors. Spontaneous extraperitoneal urinary bladder rupture is a rare cause of acute abdomen and prompt diagnosis and management can produce best clinical outcome.

Diagnosis of Bladder Diverticula with Point-of-Care Ultrasound

Case Presentation: A 65-year-old male presented to the emergency department with symptoms including fever, abnormal urinalysis, and elevated post-void residual. Point-of-care ultrasound was used to rapidly diagnose a bladder diverticulum. The patient was subsequently seen by urology for outpatient bladder repair. Discussion: Bladder diverticula, an out-pouching of the bladder, may occur congenitally or as a result of various bladder conditions and/or surgery. Although bladder diverticula are rare and often asymptomatic, severe complications including frequent recurring urinary tract infections may arise depending on the patient.

Radical Cystectomy for Intradiverticular Bladder Carcinoma: A Case Report

Herniation of bladder mucosa through the bladder wall muscle layer is known as bladder diverticulum. The incidence of bladder diverticulum is 1.7. About 0.8 to 10% of the urinary bladder diverticulum develops carcinoma. Transitional cell carcinoma is the most common. Painless hematuria is the most common clinical presentation. Different imaging modalities along with cystoscopy are the key to accurate diagnosis and staging. High grade multifocal urothelial carcinoma in the bladder diverticulum is better managed by radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Here we report a case of a 66-year old gentleman of high grade multifocal urothelial carcinoma in bladder diverticulum managed with radical cystectomy and standard pelvic lymph node dissection with an ileal conduit. Such cases have been addressed adequately in the literature, but we did not find such cases from our country.

Bladder diverticulum W. Lower (Surg. Gynec. A. Obst. No. 52.1931)

W. Lower (Surg. Gynec. A. Obst. No. 52.1931) examines his 152 cases of urinary diverticulum. bladder and in the issue of recognizing this suffering gives great value to cystoscopy and especially radiography of the bladder.

An unusual cause of free air in the abdomen: emphysematous cystitis with bladder diverticulum perforation

A 64-year-old male, with a history of chronic urinary outflow obstruction secondary to benign prostatic hyperplasia, presented with haematuria and urinary retention following spontaneous removal of his long-term catheter. The patient was septic on admission and a CT examination of the abdomen and pelvis showed an acutely inflamed urinary bladder diverticulum and extensive intra-abdominal free air. The patient was treated medically for emphysematous cystitis centred on a perforated bladder diverticulum, which was thought to be caused by the underlying infectious/inflammatory process. Alternative aetiologies for free air in the abdomen such a traumatic bladder perforation and gastrointestinal perforation were considered and excluded. The patient responded well to medical management and was discharged after an 11 day in-patient stay.

An elderly male with lower urinary tract symptoms during COVID-19 pandemic: Extraperitoneal perforation of bladder diverticulum

Case: We present a case of spontaneous extra-peritoneal rupture of an acquired diverticulum an elderly male with symptoms of bladder outlet obstruction who presented in emergency with acute abdomen. Outcome: The acute phase was managed conservatively with bladder drainage and intravenous antibiotics. He recently underwent Transurethral Resection of Prostate. He is asymptomatic on follow-up. Conclusions: Acquired bladder diverticulum are rare in adults and are mostly seen in patients with high pressure bladder due to bladder outlet obstruction. Atraumatic extraperitoneal ruptures of diverticulum are uncommonly reported.