A rare case of spontaneous rupture of the urinary bladder

An extremely rare case of spontaneous intraperitoneal rupture of the urinary bladder, caused by a combination of a tumor of the vesical wall and an impacted urethral stone, is reported. The patient's symptoms suggested a perforated hollow viscus. Under general anesthesia the urethral stone was removed, while at laparotomy a diffuse peritonitis with blood-stained purulent fluid emerging from the ruptured bladder was found. The vesical wall was repaired and the peritoneal cavity was drained. In spite of the patient's advanced age and debilitated condition and the generalized peritonitis, the postoperative course was uneventful and the patient recovered promptly. Although spontaneous rupture of this kind is rare, one needs to consider unsuspected bladder rupture in any acute abdomen, especially if the patient is in the prostatic age group or has voiding problems.