Abstract: Spontaneous bladder rupture is a rare and life-threatening condition that requires
rapid diagnosis and urgent surgical intervention. We present a clinical case of a patient with
multiple bladder ruptures and purulent-urinous peritonitis successfully treated in an
emergency setting.

The purpose of the article is to describe the features of the clinical course, surgical
treatment and postoperative approach in spontaneous bladder rupture with intra- and
extraperitoneal involvement.

The patient was admitted in critical condition with a history of stroke and severe
abdominal pain. Laboratory and imaging studies confirmed peritonitis and multiple bladder
ruptures. An emergency operation was performed with restoration of the bladder walls and
insertion of a cystostomy and a three-way catheter.
Intensive therapy, including antibiotic treatment with Meropenem and Amikacin, led to
stabilization of hemodynamics, restoration of peristalsis and normalization of diuresis. The
patient was discharged in stable condition after successful treatment.

The case highlights the importance of early surgical intervention and a multidisciplinary
approach in spontaneous bladder ruptures associated with purulent-urinous peritonitis.
Adequate antibiotic coverage and intensive care are key to improving prognosis.

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