Isolated intraperitoneal urinary bladder rupture following blunt trauma abdomen: a case study

Abstract

Introduction: Urinary bladder injuries present in emergencies in the set up of road traffic accidents with blunt trauma to the abdomen. Bladder injury can be extraperitoneal, intraperitoneal, or mixed. Intraperitoneal bladder ruptures comprise 15% of all bladder injuries. The most common feature of bladder rupture is hematuria, which can be either microscopic or gross. We hereby present a case of isolated urinary bladder intraperitoneal rupture following a roadside accident due to its rarity.

Case presentation: The 29-year-old male was brought to emergency with an alleged history of Roadside accidents with a distended abdomen. Hematuria is present on Foley’s catheterization. X-ray of the pelvis was normal. Contrast-enhanced computerized tomography whole abdomen showed bladder rupture. The patient was taken up for exploratory laparotomy and bladder repair. The postoperative period was uneventful.

Discussion: In blunt abdominal trauma, up to 90% of bladder injuries are often associated with pelvic fractures. Isolated traumatic bladder rupture is rare. In intraperitoneal bladder rupture, urine gets collected in the peritoneal cavity. Intraperitoneal bladder rupture requires exploratory laparotomy and the site of rupture is treated by suturing the bladder in two layers with absorbable sutures. Postoperative care is focused on preventing urinary catheter-associated infections.

Conclusion: This case report highlights the rare occurrence of isolated bladder rupture in cases of Road traffic accidents. Our patient recovered uneventfully after exploratory laparotomy and surgical repair.