title: Urological pathology causing free air under the diaphragm?
abstract: We report a case of long-standing, keratinising, squamous metaplasia of the bladder with undiagnosed malignant transformation to squamous cell carcinoma presenting as acute peritonitis secondary to spontaneous perforation of the bladder tumour. This presentation as an acute abdomen mimicking a perforated peptic or duodenal ulcer is the most unusual aspect of the case.
authors.affiliation: Department of Urology, Norfolk and Norwich University Hospital NHS Trust, Norwich, UK. chitalenorwich@aol.com
authors.forename: Sudhanshu
authors.initials: S
authors.lastname: Chitale
authors.forename: Manash
authors.initials: M
authors.lastname: Debbarma
authors.forename: Patrick
authors.initials: P
authors.lastname: Wilson
authors.forename: Neil
authors.initials: N
authors.lastname: Burgess
authors.forename: Danielle
authors.initials: D
authors.lastname: Peat
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D002471:Cell Transformation, Neoplastic; D003937:Diagnosis, Differential; D003964:Diaphragm; D006801:Humans; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis; D010538:Peritonitis / Q000209:etiology*; D011027:Pneumoperitoneum / Q000209:etiology*; D001749:Urinary Bladder Neoplasms / Q000150:complications*