Heleno Caio, Miranda Helena, Gotera Nico, Kloecker Goetz
Hematology and Oncology Department, University of Louisville, Louisville, KY, USA.
Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, USA.
Case Rep Oncol. 2025 May 28;18(1):845-855. doi: 10.1159/000546581. eCollection 2025 Jan-Dec.
Spontaneous bladder rupture (SBR) is a rare cause of ascites. A systematic review identified only 351 reported cases in the literature. This condition is frequently misdiagnosed due to vague symptom presentation and failure to promptly link SBR to its common risk factors, such as pelvic irradiation and alcohol intoxication. Its presentation is not different from the most common causes of ascites, and the differential diagnosis is essential.
Here, we present a case of a male with liver disease with portal hypertension, a previous history of cancer, and prior surgery with an artificial urinary sphincter placement who developed acute recurrent ascites and rapidly progressing acute kidney failure requiring dialysis. Extensive workup revealed that the kidney failure was caused by SBR, resulting in urinary ascites. The bladder rupture was treated by surgery, leading to complete resolution of the patient's symptoms.
The diagnosis of SBR requires a high level of suspicion due to its rarity and nonspecific symptoms. Here, we present an extensive review of differential diagnoses of ascites and the pathway for the final diagnosis of SBR.
自发性膀胱破裂(SBR)是腹水的罕见病因。一项系统综述在文献中仅发现351例报告病例。由于症状表现模糊以及未能及时将SBR与其常见危险因素(如盆腔放疗和酒精中毒)联系起来,这种情况经常被误诊。其表现与腹水的最常见病因无异,鉴别诊断至关重要。
在此,我们报告一例男性患者,患有肝病伴门静脉高压,既往有癌症病史,曾接受人工尿道括约肌植入手术,出现急性复发性腹水和迅速进展的急性肾衰竭,需要透析治疗。全面检查发现肾衰竭是由SBR引起的,导致尿液性腹水。膀胱破裂通过手术治疗,患者症状完全缓解。
由于SBR罕见且症状不具特异性,其诊断需要高度怀疑。在此,我们对腹水的鉴别诊断以及SBR最终诊断的途径进行了全面综述。