{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:25:09Z","timestamp":1788780309233,"version":"build-2803163510"},"reference-count":16,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,24]]},"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>We describe a case of a 3-year-old boy with Down syndrome who developed a bladder rupture as a consequence of an undiagnosed posterior urethral valve (PUV). He had a history of urinary tract infections and constipation and was acutely admitted in poor condition and underwent laparotomy that revealed peritoneal sepsis secondary to bladder perforation. Bladder was drained using a suprapubic catheter and the condition of the boy gradually improved. Once stable, a cystourethroscopy confirmed the presence of PUV. Video-urodynamic studies performed at the check cystoscopy showed the bladder to be of reduced compliance (end fill pressure at 100\u2009mL fill 30 cmH<jats:sub>2<\/jats:sub>O) with raised voiding pressures (76\u2013100 cmH<jats:sub>2<\/jats:sub>O) and significant incomplete bladder emptying. Currently, the patient is doing very well, serum creatinine has normalised, he is infection-free and thriving; his bladder is managed with a vesicostomy.<\/jats:p>","DOI":"10.1136\/bcr-2020-240857","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T12:40:19Z","timestamp":1632314419000},"page":"e240857","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous bladder rupture secondary to posterior urethral valves in a boy with Down syndrome"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-3849","authenticated-orcid":false,"given":"Massimo","family":"Garriboli","sequence":"first","affiliation":[{"name":"Department of Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK"},{"name":"Stem Cells & Regenerative Medicine Section, Developmental Biology & Cancer Programme, UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimaa","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Clothier","sequence":"additional","affiliation":[{"name":"Department of Nephro-Urology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"2025082713264825000_14.9.e240857.1","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jpedsurg.2018.10.091","article-title":"Current epidemiology and antenatal presentation of posterior urethral valves: outcome of BAPS CASS national audit","volume":"54","author":"Brownlee","year":"2019","journal-title":"J Pediatr Surg"},{"key":"2025082713264825000_14.9.e240857.2","first-page":"316","article-title":"Acute abdomen--remember spontaneous perforation of the urinary bladder","volume":"46","author":"Basavaraj","year":"2001","journal-title":"J R Coll Surg Edinb"},{"key":"2025082713264825000_14.9.e240857.3","first-page":"2119","article-title":"Idiopathic spontaneous bladder perforation: a rare case","volume":"12","author":"Uysal","year":"2015","journal-title":"Urol J"},{"key":"2025082713264825000_14.9.e240857.4","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1159\/000365690","article-title":"A case series of spontaneous rupture of the urinary bladder","volume":"8","author":"Kivlin","year":"2015","journal-title":"Curr Urol"},{"key":"2025082713264825000_14.9.e240857.5","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/BF02762118","article-title":"Spontaneous bladder rupture secondary to posterior urethral valves in a neonate","volume":"68","author":"Arora","year":"2001","journal-title":"Indian J Pediatr"},{"key":"2025082713264825000_14.9.e240857.6","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.22.3.331"},{"key":"2025082713264825000_14.9.e240857.7","doi-asserted-by":"publisher","DOI":"10.3109\/15513819109065484"},{"key":"2025082713264825000_14.9.e240857.8","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/BF00862055","article-title":"Posterior urethral valves in patients with Down syndrome","volume":"10","author":"Kupferman","year":"1996","journal-title":"Pediatr Nephrol"},{"key":"2025082713264825000_14.9.e240857.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000112915.69436.91"},{"key":"2025082713264825000_14.9.e240857.10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0181"},{"key":"2025082713264825000_14.9.e240857.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.03.114"},{"key":"2025082713264825000_14.9.e240857.12","first-page":"143","article-title":"Prevalence of lower urinary tract symptoms in individuals with down syndrome. J Ped Urol. 2014;5:844-9Kupferman JC, Stewart CL, Kaskel FJ, et al","volume":"10","author":"Mrad","year":"1996","journal-title":"Posterior urethral valves in patients with Down syndrome. Pediatr Nephrol"},{"key":"2025082713264825000_14.9.e240857.13","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/ped.12367","article-title":"Assessment of lower urinary tract function in children with Down syndrome","volume":"56","author":"Kitamura","year":"2014","journal-title":"Pediatr Int"},{"key":"2025082713264825000_14.9.e240857.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-005-1825-9"},{"key":"2025082713264825000_14.9.e240857.15","unstructured":"Down\u2019s syndrome medical interest group (DSMIG) . 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