Intraperitoneal Urinary Bladder Rupture as a Cause of Pneumoperitoneum

• Published in: The American surgeon 2023-05, Vol.89 (5), p.2079-2081
• Main Authors: Parvez M, Dar, Supreet, Kour, Ajay, Sharma, Subodh, Kumar
• Format: Article
• Language: English
• Subjects: Abdomen; Abdominal Injuries - complications; Abdominal Injuries - surgery; Bladder; Catheters; Consent; Fractures; Hematuria; Humans; Injuries; Intubation; Laparotomy; Patients; Pelvis; Pneumoperitoneum - diagnostic imaging; Pneumoperitoneum - etiology; Rupture; Rupture - surgery; Thoracic Injuries - complications; Tomography; Trauma; Urinary bladder; Urinary Bladder - injuries; Urinary Bladder Diseases - diagnosis; Urinary Bladder Diseases - diagnostic imaging; Urine; Wounds, Nonpenetrating - complications; Wounds, Nonpenetrating - surgery
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/00031348211025765

The most common cause of pneumoperitoneum in trauma patients is hollow viscus injury; however, in patients with pneumoperitoneum on imaging and normal hollow viscus during the laparotomy, other rare causes of pneumoperitoneum like intraperitoneal urinary bladder rupture should be ruled out. Urinary bladder can rupture either extraperitoneally or intraperitoneally or both. Rupture of the urinary bladder is commonly seen in patients with abdominal trauma; however, pneumoperitoneum is usually not seen in patients with traumatic bladder rupture. Intraperitoneal bladder rupture is usually due to the sudden rise in intra-abdominal pressure following abdominal or pelvic trauma. However, it is a rare cause of pneumoperitoneum and is managed by surgical repair. We present a case of blunt trauma abdomen with pneumoperitoneum due to isolated intraperitoneal bladder rupture who was managed by exploratory laparotomy and primary repair of the urinary bladder.