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Spontaneous bladder rupture secondary to warfarin overdose: a case report
Taner Sahin1, Ufuk Oner2, Omer Baser2
1Deparment of Emergency Medicine, Kayseri City Hospital affiliated with University of Health Sciences, 38100, Kayseri, Turkey. drmtsahin@gmail.com.
BMC Emergency Medicine
|December 19, 2019
Summary
Warfarin overdose can lead to spontaneous bladder rupture, a rare but fatal complication. Emergency departments should consider bladder rupture in patients with abdominal pain, hematuria, and oliguria, even without external signs of trauma.
Area of Science:
- Urology
- Emergency Medicine
- Pharmacology
Background:
- Warfarin, a vitamin K antagonist, is crucial for preventing thromboembolic events.
- Warfarin overdose can present with or without bleeding, sometimes leading to fatal outcomes.
- Spontaneous bladder rupture is an infrequent complication of warfarin overdose.
Observation:
- A 77-year-old male on warfarin presented with abdominal pain, hematuria, and oliguria.
- Imaging revealed intraperitoneal bladder rupture with an elevated INR of 13.4.
- The patient recovered after vitamin K, prothrombin complex concentrate, and surgical bladder repair.
Findings:
- Warfarin overdose can cause spontaneous bladder rupture.
- Key symptoms include abdominal pain, hematuria, oliguria, and syncope.
- Prompt diagnosis and management are critical for patient survival.
Implications:
- Emergency physicians should suspect bladder rupture in warfarin overdose cases presenting with specific symptoms.
- Early recognition and intervention can prevent fatal outcomes.
- This case highlights a rare but critical side effect of warfarin therapy.
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