Spontaneous Rupture of the Urinary Bladder: A Case Report and Review of the Literature.

Rupture of the urinary bladder in the absence of trauma is an uncommon condition with a challenging diagnosis that carries a high mortality rate and usually demands immediate surgical intervention. It is commonly associated with underlying chronic bladder pathologies, such as obstructive uropathy, chronic inflammation, and radiation cystitis; in younger patients, it can occur in the setting of substance abuse. Due to its rarity and nonspecific clinical presentation, which often mimics other more common conditions such as bowel perforation, diagnosis is often delayed and made intraoperatively. We report a rare case of atraumatic bladder rupture in a 45-year-old woman presenting with a 14-day history of abdominal pain. Diagnostic laparoscopy performed for suspected peritonitis revealed a 5-7 cm horizontal rupture of the urinary bladder, which was repaired by primary suturing. The exact cause of the rupture could not be definitively established; however, substance abuse was considered a possible contributing factor, as it was the only identifiable risk factor. This case highlights the importance of considering this condition in high-risk patients presenting with an unexplained acute abdomen, particularly when associated with hematuria and renal impairment.