Acute abdominal pain caused by spontaneous perforation of the urinary bladder.

Patients with acute spontaneous bladder perforation have the symptoms and signs of an acute condition of the abdomen which, as a surgical emergency, requires prompt operative treatment. Bladder perforation should be suspected as the cause of this abdominal catastrophe if the history and findings indicate a urinary tract disorder. If the surgeon knows preoperatively that the bladder is perforated, he is able to plan and perform the appropriate surgical procedure with greater dispatch and certainty. The correct preoperative diagnosis should be made more frequently if the primary care physician develops a greater awareness of the possibility of spontaneous bladder perforation as the cause of an acute condition of the abdomen. With earlier diagnosis and earlier surgical treatment, the present reported mortality of 25 per cent for those patients with this condition is likely to be reduced.