Spontaneous Rupture of the Bladder after a Seizure: A Pitfall of Diagnosis

Eugene Lin³, Ho Lin¹, Guang-Uei Hung², Jungle Chi-Hsiang Wu³, Huei-Loong Hsieh⁴, Tah-Chong Lin⁵, Chao-Chih Chen⁵, Chien-Hsiang Wang⁵, Mao-Sheng Lin^5*

¹Department of Life Sciences, National Chung Hsing University, Taichung.
²Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua.
³Department of Urology, Chang Bing Show Chwan Memorial Hospital, Changhua.
⁴Department of Urology, Chushang Show Chwan Hospital, Nantou.
⁵Department of Urology, Show Chwan Memorial Hospital, Changhua.

DOI: 10.4236/ss.2013.42024                

Abstract

Seizures can lead to different injuries ranging from minor lacerations to serious head injuries or bony fractures. We report a rare case of a male patient presenting with a history of a distended abdomen and gross hematuria following a seizure attack. After catheterization, the drained urine was bloodstained. On clinical suspicion of an acute abdomen, computed tomography was conducted, which showed intraperitoneal rupture of the bladder. At laparotomy, we found and repaired a laceration in the dome of the bladder in 3 layers. The postoperative period was uneventful. Our case shows that a complete abdominal examination is needed on patients following a generalized seizure episode. We also suggest that certain drugs for treating schizophrenia have anticholinergic effects, which may induce chronic urine retention. Chronic urine retention, especially in elderly male patients, may contribute to the risk of a spontaneous rupture of the bladder.

Keywords

Bladder Injury; Provoked Seizure; Intraperitoneal Bladder Rupture; Seizure

Conflicts of Interest

The authors declare no conflicts of interest.

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