Bladder perforation in the elderly: unraveling the diagnostic challenges with magnetic resonance imaging

Silva, Frederico; Lopes, Mari Angela; Valente, Dilia; Simões, Inês G.; Arez, Luísa

http://hdl.handle.net/10400.1/26542

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Bladder perforation, a significant urological emergency, presents a diagnostic challenge due to its diverse etiologies and varying clinical manifestations. This paper discusses a rare case of bladder perforation in an 87-year-old woman with a history of hypertension and previous stomach and uterine cancer. The patient was admitted with a urinary tract infection and subsequently experienced mild abdominal discomfort and reduced urinary output, prompting further investigation. Imaging studies revealed bladder wall thickening and ureterohydronephrosis, raising suspicion of a bladder tumor. Intriguingly, a catheter-related bladder perforation was identified through MRI. This case emphasizes the importance of considering bladder perforation as a potential complication, especially in elderly patients with indwelling catheters. Clinicians must maintain a high index of suspicion and employ appropriate diagnostic modalities to ensure timely recognition and suitable management of this rare condition.