Korean J Med.  2007 Jun;72(6):679-683.

Peritonitis due to spontaneous rupture of the urinary bladder in an end stage renal disease patient with anuria

• Lee WK
• Kim YS
• Kim BH
• Kim YH
• Ko YS
• Kim HK
• Lee BK

Abstract

Patients with nonfunctioning bladders, such as found in anuric renal failure, are prone to a severe form of urinary tract infection called pyocystis. Pyocystis is the accumulation of pus in the bladder. Anuric patients are often believed to be incapable of acquiring a urinary pathogen; thus, the urinary tract may be mistakenly discounted as a possible source of sepsis and bladder rupture. Although bladder rupture is normally associated with trauma, spontaneous bladder rupture may occur, especially in patients with mental disabilities, alcohol abuse and urinary tract infection. We report a rare case of a spontaneous intraperitoneal bladder rupture, probably precipitated by pyocystis. Symptoms and signs were atypical and included pain and vomiting with fever, abdominal distension and ascites. An abdominal CT and retrograde cystography showed a large quantity of intraperitoneal fluid and tearing in the dome of the bladder. Repair of the rupture site of the bladder after laparotomy was performed. However,, the patient expired due to peritonitis and pulmonary infection.

Keyword

Spontaneous rupture; Bladder; End stage renal disease; Peritonitis

MeSH Terms

Alcoholism
Anuria*
Ascites
Fever
Humans
Kidney Failure, Chronic*
Laparotomy
Peritonitis*
Renal Insufficiency
Rupture
Rupture, Spontaneous*
Sepsis
Suppuration
Tomography, X-Ray Computed
Urinary Bladder*
Urinary Tract
Urinary Tract Infections
Vomiting