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Case Reports
. 2025 May 28;18(1):845-855.
doi: 10.1159/000546581. eCollection 2025 Jan-Dec.

A Case Report of Spontaneous Bladder Rupture: An Uncommon Cause of Ascites

Caio Heleno  1 , Helena Miranda  2 , Nico Gotera  3 , Goetz Kloecker  1
Affiliations
Case Reports

A Case Report of Spontaneous Bladder Rupture: An Uncommon Cause of Ascites

Caio Heleno et al. Case Rep Oncol. .

Abstract

Introduction: Spontaneous bladder rupture (SBR) is a rare cause of ascites. A systematic review identified only 351 reported cases in the literature. This condition is frequently misdiagnosed due to vague symptom presentation and failure to promptly link SBR to its common risk factors, such as pelvic irradiation and alcohol intoxication. Its presentation is not different from the most common causes of ascites, and the differential diagnosis is essential.

Case presentation: Here, we present a case of a male with liver disease with portal hypertension, a previous history of cancer, and prior surgery with an artificial urinary sphincter placement who developed acute recurrent ascites and rapidly progressing acute kidney failure requiring dialysis. Extensive workup revealed that the kidney failure was caused by SBR, resulting in urinary ascites. The bladder rupture was treated by surgery, leading to complete resolution of the patient's symptoms.

Conclusion: The diagnosis of SBR requires a high level of suspicion due to its rarity and nonspecific symptoms. Here, we present an extensive review of differential diagnoses of ascites and the pathway for the final diagnosis of SBR.

Keywords: Acute kidney insufficiency; Ascites; Spontaneous bladder rupture.

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Conflict of interest statement

The authors declare no relevant or material financial interests related to the research described in this article.

Figures

Fig. 1.
Fig. 1.
PET-CT of the abdomen and pelvis, axial view. Most portions of ascites demonstrate mild to moderate uptake (SUV 3.5) with an intense uptake (SUV 11.6) within the loculated ascites.
Fig. 2.
Fig. 2.
PET-CT of the abdomen and pelvis, axial view. Intense uptake (SUV 11.6) within the loculated ascites anterior to the L5/sacrum and in the right and posterior pelvis.
Fig. 3.
Fig. 3.
PET-CT, lateral view. Lateral view of the loculated ascites in the right and posterior pelvis.
Fig. 4.
Fig. 4.
CT cystogram, lateral view. Lateral view of the bladder (red arrows) and urinary catheter (white arrows).
Fig. 5.
Fig. 5.
CT cystogram, lateral view. Frontal view of the bladder (red arrows).
Fig. 6.
Fig. 6.
A timeline showing creatinine level on admission, at the start of dialysis, and when he had the surgery for bladder rupture done. It showed improvement in kidney function after surgery.
See this image and copyright information in PMC

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