Isolated intraperitoneal rupture of the urinary bladder following blunt trauma abdomen

Abstract

Bladder injuries occur due to blunt, penetrating or iatrogenic trauma. The ones that occur following blunt trauma are commonly associated with pelvic fractures and can range from contusions to bladder rupture. Extraperitoneal ruptures occur more commonly than intraperitoneal ruptures. Here we present an uncommon case of intraperitoneal bladder rupture without any bony or solid organ injury. Following a fall from his motorbike a 42-year-old gentleman presented to us with abdominal pain, inability to pass urine with features of peritonism. CT cystography showed contrast leak into the peritoneal cavity. No other injuries were detected. The patient was taken up for emergency laparotomy and a full thickness rent in the bladder dome, 7 cm in length was found which was repaired in two layers with a supra pubic catheter. The patient improved post operatively and was discharged on the 3rd post-operative day. Intraperitoneal bladder ruptures are possible even without pelvic fractures and can be missed on routine imaging of the abdomen. A high degree of suspicion with appropriate imaging (CT cystography) is necessary in all such cases to ensure timely diagnosis and intervention.