Atraumatic perforation of bladder. Necessary differential in evaluation of acute condition of abdomen

Perforation of the urinary bladder without history of antecedent trauma is a rare clinical occurrence. However, in patients with acute conditions of the abdomen, especially those with previous voiding symptoms, the diagnosis should be considered. Three cases are reported. Patients presented with an atraumatic bladder perforation and peritonitis secondary to chronic inflammation, bladder outlet obstruction, and transitional cell carcinoma. After review of the literature, a classification of atraumatic bladder perforation has been revised to include presently available reports of this entity.