title: Spontaneous rupture of urinary bladder associated with massive fecal impaction (fecaloma).
abstract: 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.
authors.affiliation: Dutchess County Medical Examiner's Office, Poughkeepsie, NY, USA. dchute@co.dutchess.ny.us
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Chute
authors.forename: John
authors.initials: J
authors.lastname: Cox
authors.forename: Michael E
authors.initials: ME
authors.lastname: Archer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Bready
authors.forename: Kari
authors.initials: K
authors.lastname: Reiber
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications; D016470:Bacteremia / Q000150:complications; D005244:Fecal Impaction / Q000150:complications* / Q000473:pathology*; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000473:pathology; D008531:Megacolon / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000209:etiology / Q000473:pathology; D012559:Schizophrenia; D001743:Urinary Bladder / Q000293:injuries* / Q000473:pathology*; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000209:etiology