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. 2022 Aug:97:107458.
doi: 10.1016/j.ijscr.2022.107458. Epub 2022 Jul 28.

Generalized peritonitis secondary to spontaneous rupture of the urinary bladder in a diabetic patient: A case report

Foolad Eghbali  1 , Hesam Mosavari  2 , Ahmad Madankan  2 , Vahid Hariri  3 , Kiana Garakani  4 , Mansour Bhahdoust  5
Affiliations

Generalized peritonitis secondary to spontaneous rupture of the urinary bladder in a diabetic patient: A case report

Foolad Eghbali et al. Int J Surg Case Rep. 2022 Aug.

Abstract

Introduction and importance: Spontaneous rupture of the urinary bladder (SRUB) secondary to emphysematous cystitis(EC) in diabetic patients is extremely rare. Clinical presentations are often non-specific and display the signs and symptoms of peritonitis. The diagnosis is usually made after exploratory laparotomy.

Case report: A 70-year-old diabetic woman presented to the emergency department with sudden diffuse abdominal pain and hematuria of six hours duration. Physical examination revealed generalized peritonitis. Multi-slice abdominal and pelvic CT scans showed free air and fluid in the abdominal cavity. After proper resuscitation, the patient was transferred to the operating room for exploratory laparotomy. A 2 cm full-thickness bladder rupture was noted at the dome of the bladder, which was repaired.

Clinical discussion: We noticed free air in the urinary bladder wall postoperatively in the CT scan, which is the radiological sign of EC. The Pathology result was in concordance with the diagnosis.

Conclusions: SRUB in patients with poorly controlled diabetes and EC is highlighted in this case study. Urinary bladder rupture secondary to EC should be considered When a diabetic patient with a history of urinary symptoms presents with an acute onset of abdominal pain suggestive of peritonitis. Uneventful recovery from SRUB is dependent on early diagnosis and treatment.

Keywords: Diabetic; Laparotomy; Spontaneous rupture of the urinary bladder (SRUB).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Blue mark shows the free air in the abdominal cavity.
Fig. 2
Fig. 2
Rupture at the dome of the urinary bladder.
Fig. 3
Fig. 3
Pathology photomicrograph - the urinary bladder wall exhibited diffuse edema, hemorrhagic foci, and numerous cystic gas collections.
Fig. 4
Fig. 4
Red marks indicate gas in the bladder wall, a radiographic sign of EC. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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References

    1. Zhang Y., Yuan S., Alshayyah R.W.A., Liu W., Yu Y., Shen C., et al. Spontaneous rupture of urinary bladder: two case reports and review of literature. Front. Surg. 2021 Nov;2(8) - PMC - PubMed
    1. Celotti S., Benuzzi L., Ceriani C., D’Amore P., Foschi D., Del Re L. Laparoscopy management for spontaneous bladder rupture: a case report. J Surg Case Rep. 2021;(1) 2021 Jan. - PMC - PubMed
    1. Wakamiya T., Kuramoto T., Inagaki T. Two cases of spontaneous rupture of the urinary bladder associated with radiation cystitis, repaired with omentum covering. Hinyokika Kiyo. 2016 Oct;62(10):545–548. - PubMed
    1. Saadi M.H., Mrad Dali K., Rahoui M., Sellami A., Ben Rhouma S., Nouira Y. Rupture of urinary bladder secondary to bladder carcinoma with extensive abdominal gangrene: a case report. Int. J. Surg. Case Rep. 2021 Apr;81 - PMC - PubMed
    1. Stabile G., Cracco F., De Santo D., Zinicola G., Romano F., De Manzini N., et al. Spontaneous bladder rupture after normal vaginal delivery: description of a rare complication and systematic review of the literature. Diagn. Basel Switz. 2021 Oct 13;11(10):1885. - PMC - PubMed