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Spontaneous Rupture of Urinary Bladder Associated With Massive Fecal Impaction (Fecaloma)

Chute, Dennis J. MD; Cox, John NREMTP; Archer, Michael E. MA; Bready, Robert J. MS; Reiber, Kari MD

The American Journal of Forensic Medicine and Pathology: September 2009 - Volume 30 - Issue 3 - p 280-283
doi: 10.1097/PAF.0b013e318187e085
Case Report

We report a case of sudden death due to a catastrophic spontaneous rupture of a urinary bladder associated with megacolon due to a fecal impaction (fecaloma). The massively distended rectum and sigmoid colon filled the pelvic cavity and pressed up against the posterior aspects of the uterus, vagina, and urinary bladder. This produced bladder outlet obstruction, followed by massive dilatation and rupture of the urinary bladder, bilateral hydronephrosis, and a 3.5 liter collection of urinary fluid within the abdominal cavity. Complications of chronic constipation, fecalomas, and rupture of the urinary bladder are reviewed.

From the Dutchess County Medical Examiner's Office, Poughkeepsie, NY.

Manuscript received October 9, 2007; accepted March 20, 2008.

Reprints: Dennis J. Chute, MD, Dutchess County Medical Examiner's Office, 387 Main Street, Poughkeepsie, NY 12601. E-mail: dchute@co.dutchess.ny.us.

© 2009 Lippincott Williams & Wilkins, Inc.