The urinary bladder may rupture spontaneously or after relatively minor blunt trauma to the lower abdomen. Diagnosis can be difficult and sometimes is made at surgery.
Usual site of rupture: over the bladder dome
Risk factors:
(1) following augmentation surgery for neuropathic bladder
(2) blunt trauma to the lower abdomen
(3) binge drinking
(4) diabetes mellitus
Clinical features:
(1) diffuse suprapubic pain and/or tenderness
(2) oliguria with increasing intraperitoneal fluid (due to drainage of urine into the abdomen)
(3) tachycardia
(4) mild decrease in mean arterial pressure
(5) pain in the iliac fossa (may be mistaken for appendicitis, ovarian lesion, etc)
Imaging studies which can be helpful:
(1) ultrasonography
(2) cystography
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