Spontaneous rupture of the urinary bladder in the third trimester of pregnancy

Abstract

Spontaneous rupture of the urinary bladder is defined as rupture of the urinary bladder into the peritoneal cavity without a history of trauma 1. Aetiological factors implicated include but are not limited to radiotherapy, chronic infective diseases like tuberculosis, necrotizing cystitis and in pregnancy, bladder injuries caused in the event of uterine rupture 2. Its incidence is 1 in 126,000 hospital admissions 3. We report a rare case of spontaneous intraperitoneal rupture of the urinary bladder in the early third trimester of pregnancy. This report highlights the diagnostic challenges obstetricians and surgeons may encounter with presentations of acute abdomen in pregnancy. The patient presented with acute abdominal pain, voiding difficulty with pyrexia and features of peritonitis. At laparotomy, 3.5 litres of urine were drained from the abdominal cavity and a 6cm rent in the vault of the bladder was found. Laparotomy, bladder repair with antibiotic cover and indwelling catheterization were the basis for a favourable outcome.