Spontaneous Bladder Wall Rupture Due to Emphysematous Cystitis in a Diabetic Patient: A Case Report

Abstract

Spontaneous rupture of the urinary bladder (SRUB) secondary to emphysematous. Cystitis (EC) in diabetic patients is extremely rare. Emphysematous cystitis is a relatively rare disease entity characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging. Its disease mechanism is not well understood. Case report: A 61-year-old diabetic woman presented to the emergency department with diffuse abdominal pain and hematuria of tree hours duration. Physical examination revealed generalized abdominal tenderness. Multi-slice abdominal and pelvic CT scans showed parietal pneumatosis of bladder and communicating continuity solutions with a pre-vesical collection (extravasation of PDC into the collection). After proper resuscitation, the patient was transferred to the operating room for exploratory laparotomy. A thickness bladder rupture was noted, which was repaired. Conclusions: SRUB in patients with poorly controlled diabetes and EC is highlighted in this case study. Urinary bladder rupture secondary to EC should be considered when a diabetic patient with a history of urinary symptoms presents with an acute onset of abdominal pain. Uneventful recovery from SRUB is dependent on early diagnosis and treatment.