Subtotal vesical necrosis as a result of infected traumatic bladder hematoma: A rare case with a literature review of bladder necrosis due to hematoma

Subtotal bladder necrosis following bladder hematoma is rare. We report such a case following blunt abdominal injury. The urologic presentation was delayed hematuria which settled with conservative management but was followed by the development of urosepsis. Computed tomography scan showed full bladder due to long-standing liquified bladder hematoma. Suprapubic exploration revealed a bladder wall abscess which was drained (secondarily infected hematoma). Excision of the subtotal necrotic bladder and ileal conduit with left ureteroileal anastomosis was done later. The patient also had a simultaneous right renal and ureteric injury as an independent simultaneous event which required initial nephrostomy placement. It later healed with complete obliteration of the right renal pelvis which was managed by right nephrectomy later. A literature review of cases of vesical necrosis caused by hematomas (of different locations and etiology) is discussed.