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Spontaneous Bladder Perforation: A Case Report

Spontaneous bladder perforation is a rare disease which is either idiopathic or occurs following pathologic changes induced by infections, radiotherapy, cancer outlet obstruction, neobladder construction, cyclophosphamide therapy or bladder stones. It is usually intraperitoneal and often occurs at the dome or posterior wall of the bladder. Patients often present with sudden onset of lower abdominal pain and inability to urinate which may or may not be accompanied by hematuria and /or progressive lower abdominal distention. Some urine may be drained following urethral catheter insertion but this does not rule out the possibility of bladder perforation. Although U/S and CT scan are invaluable in diagnosis but exact diagnosis should be confirmed by cystography. Sometimes the diagnosis remains unclear at the time of diagnostic laparatomy. It should be noted that any delay in diagnosis and treatment of this condition harbours high mortality rate (about 25%). We introduce a patient who has experienced emergent laparatomy to due to acute abdominal pain due to spontaneous bladder perforation.