Abstract
IntroductionSpontaneous bladder rupture is an extremely rare clinical event that is associated with urinary ascites and apparent acute renal failure. This event is difficult to diagnose clinically, even with advanced techniques such as computed tomography; however, the timely diagnosis of this condition is critical. Here, we report a case of a patient who experienced a spontaneous intraperitoneal bladder rupture 10 years after postoperative pelvic irradiation for the treatment of uterine cancer. In this report of a rare case, we describe the contribution of the appearance of mesothelial cells in the urine to the diagnosis of this condition.Case presentationOur patient was a 71-year-old Asian woman who experienced lower abdominal pain and vomiting of two days duration. On admission, abdominal computed tomography showed intraperitoneal fluid collection and her blood tests revealed acute renal failure and hyperkalemia. She underwent hemodialysis and a transurethral catheter was inserted. The transurethral catheter was removed three days after her admission. Four days after the catheter removal, her symptoms recurred and her serum creatinine and blood urea nitrogen levels were elevated. We noted the presence of mesothelial cells in her urine, which led to a diagnosis of intraperitoneal bladder rupture. She underwent surgical repair of her bladder and hyperbaric oxygen therapy, and was discharged after her renal function returned to normal.ConclusionUrine analysis is a simple and non-invasive test and we believe that a thorough urine analysis may contribute to the early diagnosis of an intraperitoneal bladder rupture. We think that the findings presented in this case report will significantly enhance our understanding of the etiology of bladder rupture. Moreover, these case findings may help nephrologists and urologists to rapidly diagnose this condition.
Highlights
Spontaneous bladder rupture is an extremely rare clinical event that is associated with urinary ascites and apparent acute renal failure
We noted the presence of mesothelial cells in her urine, which led to a diagnosis of intraperitoneal bladder rupture
Urine analysis is a simple and non-invasive test and we believe that a thorough urine analysis may contribute to the early diagnosis of an intraperitoneal bladder rupture
Summary
In cases where mesothelial cells are observed in the patient’s urine, the possibility of an intraperitoneal bladder rupture should be considered. A urine analysis is a simple and non-invasive test that may contribute to the early diagnosis of this condition. Consent Written informed consent was obtained from the patient for publication of this case report and the accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Authors’ contributions WH, SN and TN were the major contributors in writing the manuscript. TN performed the literature review and performed the final editing of the manuscript. WH and SN performed the clinical examination of the patient. YO and SK reviewed and discussed the manuscript. All authors read and approved the final manuscript
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