Spontaneous bladder rupture after alcohol binge presenting as a rare cause of acute abdomen: A case report and review of literatures.

Bladder rupture, or perforation, is the rupture of the urinary bladder, which is often clinically classified as intraperitoneal, extraperitoneal, or combined types. Spontaneous bladder perforation is an extremely rare event and constitutes less than 2 % of bladder ruptures. It is often associated with previous bladder manipulation, lower urinary tract obstruction, instrumentation, pelvic radiotherapy or surgery, inflammation, and malignancy. Blood work will demonstrate leukocytosis with left shift, hematuria on urinalysis, and an ascites to serum creatinine ratio of more than one, which is highly suggestive of bladder rupture. A 38-year-old male patient presented with abdominal pain for 8 h and loss of consciousness lasting 4 h. The patient was acutely sick-looking with borderline blood pressure of 90/60 mmHg, pulse rate of 120, and has alcoholic breath. With a diagnosis of viscus perforation, he was operated and there was a 1 × 1 cm bladder dome perforation, which looks fresh. The ruptured edge was refreshed and repaired in two layers. The patient has recovered well, discharged and was fine on subsequent follow-ups. Bladder rupture commonly develops after blunt abdominal trauma, of which more than 60 % is extraperitoneal. Intraperitoneal bladder rupture constitutes only a small fraction of all cases of rupture. There are only a few reports of spontaneous bladder rupture in the scientific literature. The risk of bladder rupture may be increased in the alcohol-impaired patient owing to decreased bladder filling sensation and abnormal behavioral responses. Bladder rupture is a rare diagnosis in surgical patients, and spontaneous rupture is by far a very rare finding. The diagnosis of bladder perforation is often overlooked preoperatively for the obvious reason of its rarity and non-specific presentation. Early identification and timely management decrease mortality. • The rupture of the urinary bladder, also known as a perforation, is frequently clinically classified as intraperitoneal, extraperitoneal, or combined types. • Less than 2% of bladder ruptures are the result of spontaneous bladder perforation, which is additionally known as idiopathic bladder perforation. • Bladder dome is directly related to the peritoneum, and rupture at this site is almost invariably intraperitoneal. • Binge drink may depress sensation of bladder filling and alcohols diuretic effect distend bladder to the extent of rupture. • Intraperitoneal perforation always needs surgical intervention. [ABSTRACT FROM AUTHOR]