Spontaneous bladder rupture in non-augmented bladder exstrophy

Childhood spontaneous bladder rupture is an uncommon event, usually associated with bladder augmentation. Occasionally it occurs in normal bladders or non-augmented bladders with a predisposing factor. We present a unique case of misdiagnosed spontaneous bladder rupture in a non-augmented bladder exstrophy patient without evidence of lower urinary outlet obstruction. His acute abdomen mimicked appendicitis and was managed with laparoscopic exploration, intraperitoneal fluid drainage, appendectomy and bladder drainage. This case highlights the need for pediatric urological consultation by surgeons in the case of an acute abdomen with free fluid in a patient with an abnormal bladder.