Spontaneous Bladder Rupture From Pushing a Heavy Object

Abstract

Bladder rupture due to major abdominal trauma is common. Idiopathic bladder rupture without trauma and without injury-associated evidence is rare. It can mimic other causes that result in acute abdomen, such as appendicitis or peritonitis. We present the case of a 50-year-old male with right lower quadrant abdominal pain with peritoneal sign and acute urine retention. He had a history of benign prostatic hyperplasia and denied any previous trauma. Pushing a huge freezer after drinking much beer was mentioned. Series survey led to the suspicion of appendix rupture and benign prostatic hyperplasia with acute urine retention. However, laparoscopic exploration revealed intraperitoneal bladder rupture. Laparoscopic cystorrhaphy was performed with interrupted two-layer sutures. The patient recovered quickly and was discharged from hospital on the 3rd postoperative day. Spontaneous bladder rupture may result from abruptly elevated intraperitoneal pressure while the bladder is distended when pushing heavy objects or during Valsalva maneuvers. We also present the diagnostic and therapeutic value of laparoscopy for bladder rupture.