Spontaneous Rupture of the Urinary Bladder in an Elderly Diabetic Male

Spontaneous rupture of the urinary bladder (SRUB) represents an infrequent but critical urological crisis with significant morbidity and mortality risk especially in cases of septicemia. While various factors contribute to its etiology, SRUB often manifests secondary to pre-existing bladder pathologies such as chronic inflammation, neoplasia, iatrogenic radiation exposure, or obstructive uropathy. An 82-year-old male presented with acute, left-lateralized abdominal discomfort. Clinical evaluation revealed diffuse erythema and swelling within the left lower abdominal quadrant, indicative of cellulitis. Pelvic sonographic imaging detected a 4 cm fluid collection, coupled with cellulitis in the left anterolateral segment of the lower abdominal wall, stemming from a discernible defect in the anterosuperior aspect of the bladder. Drainage of 1600 cc of purulent urine was achieved via a 16-Fr urethral catheter (Safety Science Medical Company, Riyadh, Saudi Arabia). Subsequent pelvic computed tomography and cystographic studies elucidated a pathological communication between the anterior bladder wall and the left lateral abdominal wall, along with a localized urinoma. The present case underscores the imperative nature of immediate therapeutic intervention in the effective management of SRUB. Successful surgical repair and a complication-free postoperative trajectory were observed, enriching the prevailing medical literature on SRUB. The case amplifies the necessity for acute awareness, expedient diagnostic procedures, and urgent surgical intervention as key elements in optimizing patient outcomes.