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

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.