Bladder Rupture During ECT

We report a case of intraperitoneal bladder rupture during electroconvulsivee therapy. We consider that the likely cause of this complication was powerful abdominal muscle contraction, during an unmodified seizure, on a bladder distended by failure to void urine before treatment and the anticholinergic effects of medication. The literature is reviewed, a similar case is discussed, and we make recommendations for the prevention of this complication.