Intraperitoneal urinary bladder rupture

Discussion:

Complained of lower abdominal pain, constipation, and urinary retention. History of alcohol abuse.
A urinary catheter was inserted, with passage of bloody urine that quickly became clear. Blood tests showed markedly elevated creatinine (up to 3.2 mg/dL), raising the suspicion for urinary bladder rupture. On further questioning, the patient admitted to recent lower abdominal trauma.

CT with retrograde injection of diluted contrast material into the urinary bladder showed a puncture in dome of the urinary bladder. The urine that was passing into the peritoneal cavity was being absorbed by the peritoneal membrane and creatinine was thereby being introduced into the blood stream.

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