Korean Journal of Legal Medicine  2007;31(1):108-112

A Death caused by Increased Intraabdominal Pressure due to Spontaneous Intraperitoneal Bladder Rupture.

Hyoung Joong KIM 1 ; Kyung Moo YANG ; Youn Shin KIM ; Tae Jung KWON ; Joong Seok SEO

Affiliations

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Keywords

spontaneous bladder rupture; uroperitoneum; increased intraabdominal pressure; atelectasis; abdominal compartment syndrome

Country

Republic of Korea

Language

English

Abstract

A 45-year-old female with psychosis complained urological symptom of urinary incontinence and voiding difficulty with abdominal pains and expansion during her psychiatric hospitalization and suddenly collapsed at the 14th day of the admission. At autopsy, the urinary bladder showed a focal perforation and the abdominal cavity was filled with massive urinary ascites. The both lower lobes and the right upper lobe of the lung were accompanied by atelectasis. The death mechanism of this case could be explained that an increased abdominal pressure produced by massive uroperitoneum with spontaneous bladder rupture led to respiratory failure. The so-called abdominal compartment syndrome was manifested by massive uroperitoneum and caused a death. This would be the first forensic medical case that an undiagnosed spontaneous bladder rupture resulted in death of a psychiatric illness patient.