Spontaneous bladder rupture caused by a giant vesical calculus

Spontaneous rupture of the urinary bladder is an uncommon occurrence. A 36-year-old man had complaints of pain and progressive distension of abdomen and anuria for 2 days. His abdomen was tense, tender and distended with free fluid. Blood urea was 340 mg% and ascitic fluid urea was 337 mg%. An USG showed massive ascitis, a large vesical calculus and a left renal calculus. The urinary bladder could not be catheterized. Patient underwent hemodialysis and placement of abdominal drains. About 2 1 of yellow turbid fluid was drained. Cystolithotomy showed a 6 cm size impacted calculus with a rent in the dome of the bladder, which was repaired. Subsequently patient underwent percutaneous nephrolithotrypsy for left staghorn renal calculus and nephrectomy for right non-functioning kidney.