Spontaneous bladder rupture masquerading as loculated ascites with septations in postpartum - A case report

The occurrence of spontaneous bladder rupture during labor or the postpartum period after an uncomplicated vaginal delivery is exceedingly uncommon. However, we encountered a case involving spontaneous bladder rupture, which resulted in the development of localized fluid collections in the abdomen after an uncomplicated vaginal delivery. In this instance, the absence of typical peritonitis symptoms, such as abdominal pain or tenderness, and the lack of typical urological symptoms, including haematuria, dysuria, and anuria, coupled with the absence of clinical manifestations of puerperal sepsis, the absence of microbial presence in the ascitic fluid, and the patient's symptomatic amelioration following antibiotic therapy, contributed to a delay in identifying the bladder rupture. The initial management entailed the use of a percutaneous drain, followed by surgical correction of the rupture through laparotomy. This case underscores the necessity of considering intraperitoneal bladder rupture as a plausible diagnosis in cases of enclosed ascitic fluid with multiple partitions following childbirth. Additionally, it prompts considering non-surgical management for substantial intraperitoneal bladder ruptures in asymptomatic patients.