The Acute Abdomen of Unrecognized Bladder Rupture

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Abstract
RUPTURE OF the urinary bladder which is not associated with instrumentational or external trauma is uncommon. Sporadic reports of spontaneous bladder rupture have appeared,* but in the majority of instances outlet obstruction or primary bladder wall disease, ie, tuberculosis, have been obvious and long-standing precursors to the acute episode. In the past three years seven patients with what could be termed spontaneous vesical rupture have been observed at the University Hospital. The primary clinical picture on admission in six of these patients was one of a nonspecific acute abdomen of peritonitis. In five of the patients the bladder perforation either was not initially considered or was delineated only by virtue of the routine utilization of cystography in an acute abdomen of obscure etiology. Report of Cases Case 1 (02-34-98). —A 69-year-old male diabetic was admitted to the general surgery service with a three-day history of nausea, vomiting, and abdominal pain.

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