Spontaneous bladder rupture following non traumatic vaginal delivery in a multiparous woman: A rare case report

INTRODUCTION: Spontaneous bladder rupture SBR is a rare condition and often missed diagnosis, especially after a nontraumatic vaginal delivery. CASE PRESENTATION: A 34-year-old patient who had a nontraumatic vaginal delivery presented to the emergency room 7 days later with acute abdomen and anuria. Computed tomography showed free fluid in the peritoneal cavity. An intraperitoneal rupture of the bladder dome was detected, showing extravasation of contrast into the peritoneal cavity. An exploratory laparotomy revealed a perforation on the bladder dome that was sutured. CLINICAL DISCUSSION: SBR following vaginal delivery is an extremely rare condition. It represents a surgical emergency. Due to the low incidence and the presence of non-specific symptoms, diagnosis was usually delayed with an increased morbidity and mortality. Clinicians should consider this diagnosis in the presence of an acute abdominal pain associated to anuria or dysuria. We therefore recommend that the bladder be catheterized or drained before labour. CONCLUSION: SBR is a rare and life-threatening condition in post-partum. Abdominal pain with elevated serum creatinine should be suspicious of urinary bladder rupture.