• Kohei Taniguchi, Ryo Iida, Koshi Ota, Masahiko Nitta, Takuya Tsujino, Kazumasa Komura, Teruo Inamoto, Haruhito Azuma, Kazuhisa Uchiyama, and Akira Takasu.
• Department of Emergency Medicine, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan; Department of General and Gastroenterological Surgery, Osaka Medical College, Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. Electronic address: sur144@osaka-med.ac.jp.
• Am J Emerg Med. 2017 Oct 1; 35 (10): 1584.e5-1584.e7.

AbstractSpontaneous rupture of the urinary bladder (SRUB) is rare and results in a lethal condition, i.e., pan peritonitis. However, early and accurate diagnosis of SRUB is very difficult. A 54-year-old woman was transported to our hospital with suspicion of pan peritonitis after spontaneous return of circulation with pulseless electrical activity. Laboratory investigation seemed to indicate acute renal failure. Namely, her serum urea and creatinine levels were grossly elevated. Exploratory laparotomy showed unexpected rupture of urinary bladder. Her recovery after surgery was relatively smooth. SRUB should be considered in the differential diagnosis of pan peritonitis, because urgent appropriate surgical intervention can rescue patients from this rare lethal disease.Copyright © 2017 Elsevier Inc. All rights reserved.

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