As the patient had acute kidney injury and oliguria, a Foley catheter was inserted into the bladder through the urethra and 2,000 mL hemorrhagic urine was drained within 30 min, leading to the disappearance of abdominal distension. Renal function tests gradually returned to normal values the next day. Thus, the patient was thought to have urinary ascites and this assumption was confirmed by exploratory laparoscopy, which demonstrated a perforation on the bladder dome next to the extremely dilated rectum (Fig. 1). The rectum was evacuated, the bladder was repaired, and postoperative cystographic investigation on the 15th day was found to be normal.
Fig. 1
A photograph from exploratory laparoscopy, which demonstrated a perforation on the bladder dome
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2.
Spontaneous intra-peritoneal rupture of bladder secondary to chronic constipation and fecal impaction.
